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GP practices must merge to survive, GP leaders warn

GPs will have to merge, federate or form ‘super practices’ to survive in the new NHS, GP leaders have warned.

Debating the topic at the Pulse Live conference in Birmingham today, a group of GP leaders agreed that the traditional ‘cottage industry’ model of general practice was not fit for the future and that practices will have to evolve or face closure.

They said that new NHS landscape of competition, care integration and quality standards meant that economies of scale were needed for GP practices to survive.

Birmingham LMC executive secretary Dr Bob Morley argued GPs should learn from the legal and accountancy industries and merge together to keep their competitive edge.

He said: ‘For the traditional cottage industry to survive [we have to] look outside general practice, look at what has happened to firms of lawyers and accountants. How have they managed to maintain their businesses in a competitive environment: quite simply by merging. And that is what we felt had to do in our practice.

‘Change is inevitable and change is happening faster and faster in general practice. We have to understand that to keep what we value we have to look in a radically different direction. We have to think big. We need to have larger different models to survive, compete and prosper. If we want to keep what we’ve got then we must change.’

Dr Penny Newman, a GP and consultant in public health in NHS Midlands and East, warned GPs that they needs to create the ‘headspace’ to plan for the future of their practice, arguing in favour of practice federations and sessional GPs coming together to form ‘locum chambers’.

She said: ‘We work 12-hour days and we are also overwhelmed with admin, QOF and long term conditions and we are just trying to carry on, and very few have long-term plans for their practice.’

She added: ‘Is the cottage industry model fit for the future? No, because care is too complex. Can traditional partnerships survive? I don’t know. How can they adapt? GPs need to get some headspace to think about this. Get curious and speak to people.’

Nigel Edwards, senior fellow at the King’s Fund, argued in favour of ‘super practices’ that could hire their own specialists, for example in geriatrics, and have their own diagnostic hub to reduce referral barriers.

He said: ‘The challenge is to have the best of both worlds. I want the best I want the best of high-touch relationship-based primary care that general practice has done so well. I want high quality access to practices when I need it, and I want access to specialists as well. How might we do this? The answer that seems to be emerging is to try and get larger groups and networks to bring generalists together and bring together into a big enough scale.’

‘When we have got the scale we can hand over all of the management of domicillary care and social care to the practices.’