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Twenty struggling practices forced into 100k-patient mega merger



Exclusive Twenty practices in Walsall are planning to merge to form a 100,000-patient super practice in an effort to shore up finances.

Pulse understands that over one third of NHS Walsall CCG’s 59 practices have expressed an interest in forming a super practice that could see all the practices joining one contract.

GP leaders in the area have said that while the contractual framework around the super practice is still being finalised, it would likely take on a similar model as Modality – a super practice that covers 25 practices with 150,000 patients in Hull, Birmingham, Sandwell and Walsall all under one contract.

Dr Uzma Ahmad, medical secretary at Walsall LMC, described the plans as ‘a good initiative if taken locally’ although the merger is still ‘in the initial stage of doing their due diligence about the accounts part of it’.

She said some of the practices that are looking to join the super practice are small, ‘atypical’ practices and are ‘finding it difficult to be viable’.

Dr Ahmad added that other practices are facing recruitment issues as partners plan to retire soon.

She told Pulse: ‘It’s a high deprivation area and we do know that the Carr-Hill formula – it’s not really reflected into the global sum, so there are practices with high need and they actually don’t get what they deserve because of how it’s calculated.’

She added that by working at scale, the practices will ‘get some advantages in working on a scale where they can get some support financially’.

NHS England has previously said it would review the Carr-Hill formula after agreeing with the GPC that some practices’ situation was not adequately captured by the formula but added that any updates would not come until April 2018.

Dr Ahmad said she has worked with NHS Walsall CCG in identifying the top ‘atypical’ practices in the area but said she didn’t know how many of those practices would be joining the super practice.

A spokesperson for NHS Walsall CCG said they are ‘aware of a proposal’ to form a super practice.

But she said: ‘The CCG understands that discussions are at a very early stage and are therefore unable to speculate on the number of practices that may join or the practice population served.’  

The rise of the super-practice

Pulse has been charting the rise of the superpractice, revealing this year that a super-practice in Birmingham is expanding to cover a population of up to 370,000 patients, making it the largest GP partnership in England.

It follows a number of other superpractices, including Modality, which recently expanded into Hull with the addition of four GP practices in the city.

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.

Meanwhile David Mowat, the former health minister responsible for general practice, said that the current 7,500 GP practices in England may reduce to just 1,500 ‘hubs’ in future.

Lakeside Healthcare in the East Midlands has said it is making visits to China and India to attract young medical students to come and train as GPs in their super practice, in a bid to increase its list size to 300,000 patients.