The future of general practice is best served by aggregating at scale in such a way that it can deliver the improved quality care and access that patients require, and offer a wide range of services that at present are being commissioned in hospitals.
That is why we decided to form what will become the largest GP practice in the UK next year. We have chosen to go down the route of a partnership merger model because that leaves us with one voice, one organisational governance framework and one clinical governance framework. We considered a looser federation structure, but came to the decision that when we approach commissioners and fellow providers, if we can say we are speaking on behalf of 100,000 patients, we are in a much stronger position.
Our plan is to build a practice list of 350,000 patients in a geographically co-located area in the broader central Midlands. That means that we deliver services to those patients in a much more efficient manner.
The model of care we propose to deliver via our multispecialty community provider vanguard pilot, through a delegated budget, means we will be able to change fundamentally the offer of general practice to patients.
We are in a much stronger position
The sickest patients, with multiple long-term conditions, who now have a poorly co-ordinated service that results in unnecessary, unhelpful hospital admissions at enormous cost to the health economy, will be offered a model of care provided by GPs with a view to frequent, longer appointments to optimise their care so they never end up in hospital.
Other health economies have shown this can reduce the cost of healthcare for this group by 20%, so if we did this across the country, we would go a long way towards meeting the £22bn cost saving by 2020.
Individual GPs in the organisation benefit from a larger whole that is more organisationally and financially stable. It is able to offer portfolio careers within the organisation – most partners will not work as 8-10 session GPs but will do other things that maintain their interest.
Within the organisation there are about 30 GPSIs but practices have not been able use them because it is hard to organise backfill. In a bigger group this is much easier to do.
Dr Peter Wilczynski is chair of Lakeside Healthcare and a GP in Corby