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65,000-patient super-practice looks to expand across England



A West Midlands ’super-practice’ covering 65,000 patients is set to expand across England following a number of approaches from other practices.

The Modality Partnership, which currently spans 15 practices across Birmingham and Sandwell – including the Bellevue Medical Centre where Professor Steve Field, the chief inspector of general practice, is a partner – has been approached by practices in London among other areas interested in joining the organisation.

Its executive director told Pulse the last 12 months had seen an increasing number of approaches from practices around the UK, both as part of established federations and individual practices.

The practices have expressed an interest in replicating the Modality model across the country as part of the same partnership, which would centralise back-office functions in a bid to increase efficiency and sustainability.

As part of the potential arrangements, the practices elsewhere would continue to tailor their service to their local population and commissioning arrangements.

The GPC favours super-practices as one of the few models which could retain the ‘core principles of general practice’ and working at scale is one of the principles set out in NHS England’s, Five Year Forward View.

Modality executive director Dr Naresh Rati told Pulse: ‘Over the last 12 months, we’ve been approached by a number of organisations suggesting “maybe we can scale-up jointly, and scale and replicate the [Modality] model in different parts of the country”.’

‘We’ve been established seven or eight years now, and for want of a better word we’ve done the back-office stuff… there’s an opportunity for us to scale that up quickly for patients’ benefit.

‘Patients in London, for example, will still see the front door entrance to their GP practice that they’re familiar with. But in the back end, we’ll be able to quickly centralise operations – which some practices are struggling with.’

What is a super-practice?

 Super practice 580x837px

Super practice 580x837px

The Midlands have given rise to several super-practice ventures in the last 12 months.

These include the 100,000 patient, 62 partner practice at Lakeside Healthcare, East Midlands and the gigantic Our Health Partnership in Birmingham and Sutton Coldfield, which involves 200 GP partners and a list of 275,000 patients, which Pulse first revealed in August.

Often formed by a series of list mergers, super-practices are typically run by a small group of elected or appointed partners.

The GPC defines it as one GP practice covering a very large patient population, potentially in excess of 100,000, and which operates from a number of sites despite being a single organisation.

The GPC said in its vision for the future that super-practices could be one of the few ways of ensuring the ‘core principles’ of general practice are retained, with GP list sizes growing by 28% since 2002.

And NHS England is keen for these larger GP organisations to take on new functions. NHS England chief executive Simon Stevens said accountable care organisations are the future, saying it was ‘mission-critical’ to ‘blur the old boundaries between GP and hospital care’.