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The commissioning landscape awaiting newly created GP federations

The success of the GP Federation lies in its ability to work with and understand the different commissioners that exist in the UK's complex health economy.

The benefits of a GP Practice joining a Federation are there for all to see. Better recruitment, retention, improved income by working to scale, a coherent ethos and a better patient experience as a result.  But these benefits are reliant on the ability of the newly created federation to forge successful relationships with those commissioning their services.

1. The Clinical Commissioning Group is an obvious win but one frought with difficulty as many of the CCGs across the UK are not set up to operate efficiently and antiquated ways of working and convention can govern their decision making.  However in the CCGs that I have experienced that are switched on, then negotiations, relationships and new ways of working are welcomed and GP Practices speaking as one voice and at scale as part of a federation can experience the true benefits.

2. There are great examples throughout the UK of Hospital Trusts working well with GP Federations as their commissioned services costed through the Payment by Results Tarriff, created by NHS England with Monitor, ensure costs are more clearly identified.  The benefit to these Trusts of dealing with GP Practices that are part of a larger federation and speak their language are clear.

3. The private sector, often the elderley covered by health insurance companies for blood tests, MRSA swabs, pre-operation assessment, post operation follow up, wound management and rehabilitiation work, can also just as easily be applied to NHS patients.  This is work that is available to federations and can provide the GP Practice with an excellent revenue stream given the need to free up consultants to focus on what they do best - surgical procedures.

4.Community services are often delivered in a block contract and it is incredibly difficult to identify the true individual cost of services as a result.  There are many GP Practices out there delivering services for free or at a loss as part of a long standing arrangement.  There is no justification for this, and negotiations must take the position that the work needs to be paid for, deliverable and therefore sustainable.

5. Collaboration is a key area for GP Federations and there are many successful examples of this out there.  A private sector company with excellent back office capability and an experienced call centre team can easily benefit from the clinical skills and services of a GP Federation in providing an out of hours service with both organisations playing to their strengths.

Scott Mckenzie

Scott Mckenzie

NHS Management Consultant

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