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Developing a federated model of General Practice - Getting started!

In exactly the same way you would if you were building a house, you need to start with the foundations. By getting the company principles right you will save a lot of time and a lot of money in the long run.

If we stick with the housing analogy you need a small team of people to develop this work; it does not require someone from every practice interested in joining. You need to empower the team (best size is about 8 to 10 people) to work through the questions and scenarios, and provide the answers they believe best reflect the ethos locally for forming the federation.

To further explain, in developing these principles you will in effect be laying down 90% of the governance for the company, and that company will be governed by company law, meaning there is a limit to what you can and can't do.

A good facilitator will be able to question you and test your answers against real life scenarios to ensure your documents are fair, robust, clear and concise, and will convert easily to the legal documentation the lawyers incorporating your company will develop for you.

As examples I suggest you ensure clarity over,

  • Terminology
  • General information about the company
  • Shares
  • NHS Pensions Authority
  • Funding Rules for Practices
  • Directors
  • Decision Making
  • Joining and leaving 

There is a lot of essential information required; however, a good facilitator will be able to ensure you provide everything required.

The process you use therefore needs to allow you to understand all that's required to develop your company, and at the same time, needs to allow you to provide easy to understand documents for those interested in joining.

The documents are then presented within a "launch meeting" for the company to all interested in joining. This also provides an opportunity for all outstanding questions to be answered.

Those attending can then be given a fixed amount of time to return to their practices for a wider debate between partners and staff.  Any questions arising from this should come back to the work group, whereupon answers can be shared with everyone who attended the launch.  Ultimately there will come a point in time when a decision needs to be made on whether or not the practices wish to join.

You can though be rest assured that it is often the case that one or two practices will choose not to join.  This though is not an issue and should not stop those who want to progress from forming a company.

In our next issue, we will look at the a couple of common questions that come up as the company is being incorporated relating to VAT and getting the finances moving in support of developing a highly successful federation. 

If you wish to discuss any points raised in this blog or if want to know more about our federation support services, please get in touch with our team on 0191 653 1022.

Scott Mckenzie

Scott Mckenzie

NHS Management Consultant

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