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At the heart of general practice since 1960

‘We will become the largest GP practice in the UK’

Dr Peter Wilczynski on his new super-practice

Dr peter wilczynski 3000x2000px

The future of general practice is best served by aggregating at scale in such a way that it can deliver the improved quality care and access that patients require, and offer a wide range of services that at present are being commissioned in hospitals.

That is why we decided to form what will become the largest GP practice in the UK next year. We have chosen to go down the route of a partnership merger model because that leaves us with one voice, one organisational governance framework and one clinical governance framework. We considered a looser federation structure, but came to the decision that when we approach commissioners and fellow providers, if we can say we are speaking on behalf of 100,000 patients, we are in a much stronger position.

Our plan is to build a practice list of 350,000 patients in a geographically co-located area in the broader central Midlands. That means that we deliver services to those patients in a much more efficient manner.

The model of care we propose to deliver via our multispecialty community provider vanguard pilot, through a delegated budget, means we will be able to change fundamentally the offer of general practice to patients.

We are in a much stronger position

The sickest patients, with multiple long-term conditions, who now have a poorly co-ordinated service that results in unnecessary, unhelpful hospital admissions at enormous cost to the health economy, will be offered a model of care provided by GPs with a view to frequent, longer appointments to optimise their care so they never end up in hospital.

Other health economies have shown this can reduce the cost of healthcare for this group by 20%, so if we did this across the country, we would go a long way towards meeting the £22bn cost saving by 2020.

Individual GPs in the organisation benefit from a larger whole that is more organisationally and financially stable. It is able to offer portfolio careers within the organisation – most partners will not work as 8-10 session GPs but will do other things that maintain their interest.

Within the organisation there are about 30 GPSIs but practices have not been able use them because it is hard to organise backfill. In a bigger group this is much easier to do.

Dr Peter Wilczynski is chair of Lakeside Healthcare and a GP in Corby

Readers' comments (12)

  • Do you have ready access to capital to resolve some of the issues this merger creates with existing partners and estates?

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  • "The sickest patients, with multiple long-term conditions, who now have a poorly co-ordinated service that results in unnecessary, unhelpful hospital admissions at enormous cost to the health economy, will be offered a model of care provided by GPs with a view to frequent, longer appointments to optimise their care so they never end up in hospital"......

    Impossible! Sometimes the best and safest place some patients need to be is in hospital. You can't always avoid admissions.

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  • Just looked at the Lakeside Healthcare website and they dont appear to be doing anything special and the three current practices have different opening hours and I assume some form of autonomy. What worries me about these super practices and those 'joining' Trusts is that future contract negotiations are going to be impossible because of the total fragmentation of GP.

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  • Becoming supersized increases the chances of you winning bids.In the jargon you have "increased leverage"

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  • Plenty of vision but not much detail.
    1. What are the contractual arrangements between doctors with doctors, doctors with staff etc (own contracts or BMA's, company model with a CEO...)?
    2. How many £££s in "delegated budgets," £/patients?
    3. Do they include other members of primary care, like chemists and optometrists.
    4. Are they acting strictly as commissioners or there is an element of provision? In other words, are they buying services from, possibly, their own companies.
    5. Do they intergrade local hospitals?
    Looking forward to a really informative and comprehensive description of the model, or a link we can look it up.

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  • Sounds utterly ghastly. Would not want to be a patient or a GP in Corby.

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  • i know trainees that have come through similar practice arrangements and they've said it's horrid to work there. nobody talks to each other, nobody knows each other, nobody knows who's in charge (as there are around 30 partners), nobody takes any responsibility and the whole thing is crap. but the pay is good.

    also "longer appointments to optimise their care so they never end up in hospital."

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  • The biggest moan that patients have in these places is they never get to see the same GP twice.

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  • Don't have a stroke or MI there, you won't be in hospital. There is such a thing as a hospital dependent patient.
    How much per patient year? That is the crux of the affair. £100 as some or £500 as others. The eternal problem in the NHS of inequality in funding.

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  • "The future of general practice is best served by aggregating at scale in such a way that it can deliver the improved quality care and access that patients require, and offer a wide range of services that at present are being commissioned in hospitals"- the whole basis of everything in GP at the moment is to keep patients out of hospital- this may work for a while but it is essentially only a delaying tactic. This statement is also delivered as if it is a fact but actually patients want poersonalised care not some anonymous massive combine. GPs should be advised not to jump lemming like into these unproven structures until we can really see what happens inside them.

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