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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
  • 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.

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