I find the choice of some PCTs to preclude bids for GP practices from solo practitioners perplexing.
An advertisement for the procurement of GP practices in Sefton said: ‘Bids will not be considered that will result in a single-handed GP practice. The only exception to this would be consideration of bids from an existing provider whose practice boundaries overlap.’
First of all, there is no evidence that single-handed practices are inferior. In fact, a recent Danish study showed the opposite.1
Single-handed practices had far more positive assessments of accessibility from patients than partnership practices, especially availability by phone and waiting time prior to an appointment.
Secondly, in the above-mentioned bidding process, one practice list is of only 1,784 patients – and a list of this size could be covered by a single GP.
Thirdly, being a solo GP would not be a preclusion if your practice boundaries overlap with those of the practice under procurement. The process highlights how merging into groups and bids from big providers are facilitated by PCTs.
One day there will probably be a revival of solo practices, with GPs salaried by a private firm, working for the NHS.
At that point we will have turned a full 360 degrees – with the introduction of an additional bureaucratic layer between the commissioner and provider.
From Dr Edoardo Cervoni
1 Heje HN, Olesen F and Vedsted P. Patients’ assessment of general practitioners. Association with type of practice. Ugeskr Laeger 2010;172:1119-26. (Article in Danish)