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GP practice numbers could go from 7,500 ‘to 1,500 super hubs’, minister says



David Mowat, the junior health minister responsible for general practice, has said that the current 7,500 GP practices in England may reduce to just 1,500 in future.

He said that this comes as they are ‘finding that it is working better’ for GP practices to have lists of 35,000-40,000 patients, and that therefore they were ‘migrating over a period of time’ towards the model.

Mr Mowat was speaking in a Westminster Hall debate about the rising cost of GP indemnity when he was asked what the future model of general practice may look like.

He responded: ‘Increasingly across the country… we are finding that it’s working better by putting GP practices into hubs of 35,000-40,000 people, where they are able to employ pharmacists, to employ physios, to do more things at scale than perhaps they would be able to do just in a single practice… with two or three GPs, which is historically what has been the case.

‘So we are sort of migrating over a period of time to a position in which there may be – well, there are 7,500 GP practices around the country – to something more like 1,500 of these sort of super hubs.’

But he added that it would be ‘a long road’ until this became a reality, due to the time it is taking to roll out a new contractual model.

He said: ‘Although it is also true to say that the contract position hasn’t caught up with that, and that is a long road.’

The news comes as the Government’s new ‘voluntary’ contract for multispecialty community providers (MCP) – the new GP model covering lists of at least 30,000 patients – has run into delays with none of the six pilot areas around the country set to actually go live with their contracts from next month as was originally planned.

It also comes as the Department of Health has mandated NHS England to ensure that half of the country is covered by the new care models by 2020.

And even the GPC has said in its vision for the future of general practice that super-practices could be one of the few ways of ensuring the ‘core principles’ of general practice are retained.

But the GPC is fighting for practices to be able to keep the GMS contract alongside the new contract, and has advised practices not to feel pressured to ditch their current contracts to enter new models.

The Government has previously said practices on the MCP contract would provide seven-day access, but as Pulse recently revealed at least one of the pilot areas has silently ditched that element.

Little has been revealed about what will actually be asked of practices on the new contract, except that funding will be linked to outcomes. This is expected to include funding decreasing if they fail to reduce hospital admissions.

Pulse predicted the rise of the super practice as early as two years ago, as average list sizes had already risen by 28% between 2002 and 2015.