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Developing a federated model of General Practice: Why change is essential

  • 16th December 2014

Developing a federated model of General Practice: Why change is essential

CCG authorisation was hailed at the time as delivering greater opportunity and better patient care, as was written in the 2012, 2013, and 2014 commissioning plans.  These plans compared with what has actually been delivered, in many areas, tend to differ greatly.  Has your CCG plan been delivered? Compare the plan to the reality and what does it tell you?

General Practice, as providers of primary medical services, are at a crossroads; potentially a defining moment in the history of the NHS. What is clear is that it faces many challenges and change is required.

This time something radically different is needed that will allow all practices to re-think their delivery model; developing new ways of working to meet the challenges that are here and now.

In the current climate not changing and not embracing a federated model means accepting:

The ongoing pay freeze, which could last until 2018/19;

  • A 30% reduction in QoF income with ever higher thresholds to achieve QoF targets. In essence more work for the same money;
  • Any Qualified Provider (AQP) tenders for Local Enhanced Services income. Facing the real possibility of losing this vital income from the practice.  This will be yet another erosion of income unless practices respond to this quickly;
  • Pensions changes, with increased contributions
  • Minimum Practice Income Guarantee being phased out in next 7 years;
  • The cost of CQC registration;
  • Last but by no means least the potential requirement from 2015 for seven day opening.

To this list there is the added complication of CCG co-commissioning General Practice, which from historic examples of Secondary Care commissioning, has not always delivered the required outcomes to move services from in hospital to out of hospital. If this lack of success is repeated in co-commissioning General Practice it could spell disaster, particularly as General Practice may then become the only focus for CCGs, who cannot shape hospital services.

"We must take change by the hand or rest assuredly; change will take us by the throat." Winston Churchill, Former British Prime Minister

What does it take to deliver real change; change that will stand the test of time, the test of day to day life and the cry of “but we have always done it that way” (even though doing it “that way” doesn’t deliver the outcomes you want or need).

Six steps, and a lot of hard work, are what it takes. If you follow these six steps I GUARANTEE you will achieve the outcomes you desire through a change in work practices aligned to a shift in mindset to deliver your stated outcomes.

Who writes this?

Scott Mckenzie

Scott Mckenzie

NHS Management Consultant / Working at Scale
Find out more about Scott
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