Request a Quote

Request a Quote

Please complete the form below, we’d love to hear from you!

Developing a Federated model of General Practice - why now?

  • 28th January 2014

Developing a Federated model of General Practice - why now?

Are you happy to get by on your core Primary Medical Service contract?  Assuming the answer is no, please read on.

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 standing still to try and address these is not an option.

Keep doing what you have always done, and you can expect to keep getting what you have always got.  In the current climate that 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;
  • Minimum Practice Income Guarantee being phased out in next 7 years;
  • The cost of CQC registration;
  • Last, but by no means least the requirement from 2015 for seven day opening.

There are though options for practices to explore.  This of course means doing something different; tinkering around the edges will get you an outcome that goes with that, and it will not be enough. 

This time you need something radically different 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.

As with everything in life there are of course options. You can do nothing; however, this means accepting; 

  • The continued decline in income - no new money until at least 2018;
  • The inability to control your future direction;
  • The loss of independence, with the likelihood of others telling you what to do;
  • The risk of increased dissatisfaction with your role;
  • The very real risk of Practices becoming financially unstable and/or unviable;
  • Redundancies for clinical and administration staff (albeit this may not happening
    immediately);
  • A forced increase hours, both in and out of hours, particularly as seven day working is looking large on the horizon;
  • The forced increased quantity of work, without resources, as work is simply shifted from secondary care in to primary care; unless you are organised you will end up accepting this with no increase in income.

Alternatively, you could look to become employed and work for someone else? 

  • Working for another company as a salaried staff member; salaried mans pay and conditions, with a lack of control.
  • Working for ospital Trust; on contract to them. Again this is likely to mean pay, conditions and a lack of control over what you do or when you do it.

Why instead don't you just take control? While this will mean working to implement change, you will be in control of the change and working with people you know and trust. Nobody can force you to do anything you don't want to; this will be a positive choice to become engaged in the process.

If you take the step towards forming a federation this will allow local practices to play to their strongest suit, as it will be;

  • Locally run,
  • Meeting local needs,
  • Serving local patients,
  • Size in numbers adds strength.

The key benefits of a federated model are;

  • Provides a vehicle and skills to successfully bid for services; forming a legal entity is the only way for many NHS contracts.
  • Potential loss of income much greater than initial investments to set the company up.
  • Company allows you to compete with other providers.
  • Support practices in providing quality services for all our patients.
  • Using size as a strength to reduce expenses and avoid duplication.
  • Ability to deal more easily on behalf of the Practices through one organisation
  • Provides a platform for innovation.
  • Locally  run, by local GP Practice stakeholders, to meet local needs.
  • Company provides ability to partner with hospital and other local providers, whereas  individual practices are highly unlikely to be able to partner or bid.

A federation is not designed solely for the benefit of the Practices, as there  are a number of patent benefits easily attained. Feedback from within our work has been that patients like the idea of Practices coming together to respond to the challenges the Health & Social Care Act has brought them. Patients also  very much like that federations are locally run, by local GPs, for local people. 

Patients also understand with Practices pulling together and supporting each other this  potentially avoids service fragmentation and supports continuity of care.  Additionally, local services help avoid unnecessary referrals and admissions to hospital.

Now is the  time for your practice to weigh up the benefits? Now is the time to make a conscious decision on the best way forward for you as a practice.  Don't leave it to happen to you, take a positive step, and make a decision. Take Control NOW!

For more information on how we can support you in forming a federation, or to arrange to speak to one of our experts, please get in touch for a no obligation discussion.

Who writes this?

Scott Mckenzie

Scott Mckenzie

NHS Management Consultant / Working at Scale
Find out more about Scott
  • Very smooth changeover to BW, with good communication at all times. Very efficient in the production of the accounts (as promised) and the Partners are delighted with the advice received to date.

    Paul Atkinson, Practice Manager
    Netherfield House Surgery, Northumberland
  • BW Medical Accountants have a good working knowledge of General Practice and are keenly aware of the challenges Practices face within the changing environment of the NHS.  Benfield Park have been very impressed by the way BW Medical continue to deliver the range of services they provide from Accounts to Tax and NHS Pension advice. 

    We have found Practice consultation and engagement from BW Medical specifically helpful to shape the future of the Practice.

    Jonathan McCutcheon, Practice Manager
    Benfield Park Medical Group, Newcastle
  • We had no hesitation in moving to BW Medical Accountants.  For any business your accountant is integral, and for us one of the most important factors to this relationship is to have a personal and trusting approach, which BW have undoubtedly achieved. 

    The service we receive and the interest they show in our practice assures us that they have a genuine interest in us and commitment to us.  More importantly they are always helpful and polite to answer even the dumbest of questions!  They give us confidence and reassurance knowing that they are always very up-to-date with all the numerous changes within general practice and we would have no hesitation in recommending them to other practices seeking a professional and personal accountancy service.

    Jackie Rotherham, Practice Manager
    The James Street Family Practice, Lincolnshire
  • We moved to BW Medical Accountants in 2013 and we are delighted that we have.  Having been in the same business for over 20 years it is important to have a relationship with the accountancy team but most importantly you need to have trust.  We made the decision to move our business to BW Medical Accountants and having worked with the Team especially Tina we are very satisfied.  Tina going through the accounts brought to our attention many things that I was not aware of in the past.  The first years' experience can only be described as excellent.

    Customer service is first and foremost with BW and this shines through as each and every one of them are approachable, helpful and most importantly understand and know the business.  General practice is complex and is going to get more complex in the coming years.  We need Accountants who truly understand our business. We as a practice and as individuals would certainly recommend BW Medical Accountants.

    Gloria Middleton, Managing Partner
    Westbourne Medical Group, Sunderland
  • We changed to BW Medical Accountants during this financial year and I would say we have just had the most transparent and understandable end of year meeting and the best planning advice I have ever had in 16 years of practice.

    Dr H Jervis, Partner
    Temple Sowerby Medical Practice, Cumbria

Newsletter Signup

Loading...