The RCGP chair has sounded the death knell for small practices, saying the landscape of general practice was ‘too complicated’ for single-handed GPs to survive on their own.
Professor Clare Gerada told Pulse that single-handed practices were ‘really good organisations’, but that they were likely to become ‘financially unsustainable’ if they continue to work alone.
The RCGP chair was speaking at a workshop on federations organised by Newham CCG and the RCGP, where she said that new ‘integrated care co-operatives’ should be set up to meet the Government’s aim for GP-led 24/7 community care.
The idea follows the publication of controversial College recommendations that GPs should work together as federations to commission 24/7 services for patients with complex comorbidities.
She said the organisations will be ‘geographically bound, population based integrated care co-operatives’, which would ‘sit between federations and CCGs’ she said. They would be the ‘optimal size’ for risk pooling and local and national accountability’, she added.
The ICCs would ‘bring together all relevant health care providers- within a contiguous and geographically bound authority area – as not-for-profit organisations with resources allocated and distributed according to the best needs of the population’.
The aims of the new organisations would be to ensure access and equity and reduce fragmentation of care, she said.
She told delegates: ‘The ICC allows for the provision of 24/7 community care, chronic disease management, urgent care outside hospitals, care for the frail elderly, end-of-life care and the like, as well as creating better joint working between all parts of the local health economy.’
Professor Gerada also warned that single-handed practitioners will be unable to remain financially viable unless they join federations.
She said: ‘There is the CQC, QOF, CCGs – keeping up with it is a nightmare.’
When asked whether single-handed practitioners can remain financially sustainable, she said: ‘Yes and no. Yes, but only if they are part of a network or federation. No, if they are on their own – they will be financially unsustainable.’