General practitioner GP practices England Northern Ireland Wales

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Preparing for the future

How can GPs prepare for the future?

The sooner practices begin to prepare for changes in primary care, the more chance they will have of protecting themselves against new emerging threats and making the most of any opportunities that may present themselves.

The importance of planning change, gaining commitment and exploring the feelings of partners, staff and patients cannot be underestimated.  

The majority of GP partners will be used to the relative autonomy that traditional general practice structures afford them. This has meant that GPs have been able to respond quickly to change.

Some may worry that the development of GP networks will lead to some or all of this control being lost. Bigger partnerships involving more GPs or shareholders could lead to the feeling that power is diminishing.

The General Practitioners Committee believes that it is still possible to ensure that the traditions, values and history of UK general practice are used to drive improvements that benefit patients, practices and the wider NHS.  


What GP partners should be asking themselves

  • Do partners and practice staff frequently allocate time to consider the future?
  • Has the practice considered its long-term viability and sustainability?
  • Do partners regularly review quality and regulation?
  • Have discussions around the implications of the health reforms and the 2013/14 contract imposition started within the practice and with patients?
  • Has the practice considered threats, such as:
    - pressures to deliver more despite shrinking resource
    - increasing consultation times for an ageing patient population with (often multiple) complex conditions
    - the likelihood of reduced access for patients with less serious ailments
    - potential staff redundancies?
  • Has the practice sought advice from peers, other local GPs or Local Medical Committee officers or professional consultancy experts who have experience of establishing formal or informal structures?

Why form a GP network?

Some GPs are already asking these questions

  • Why should practices thinking about forming a GP network consider?
  • Are all practices really faced with the prospect of forming larger organisations in order to survive?
  • Have we not already seen countless NHS re-organisations come and go, maintained excellent healthcare for our patients and survived to tell the tale?

Depending on geographical location and local patient need, the nature of the structure practices may choose to adopt can and will vary. Some will implement more formal organisational structures, whilst others may determine that patients will gain the most benefit from smaller scale, flexible alliances or ventures that can be adapted as the needs of their local patients change over time.

Practice considerations will vary depending on whether they are urban or rural. Bringing a group of local practices into one purpose built premises may not necessarily be suitable for rural patients scattered across remote parts of the UK. If they feel unable or less willing to travel to see their GP, the risk for those patients requiring more expensive future treatments will inevitably rise.

This does not necessarily mean rural practices cannot collaborate to improve certain services. Indeed, existing GP out of hours cooperatives already successfully cover considerable rural areas (see case study below).

Practices have had experience of establishing and maintaining a variety of collaborative alliances for a considerable number of years, so this will not be new to GPs. Nevertheless, the NHS has rarely been under so much pressure to make the most of finite resources. As always, the role GP practices have in maintaining high quality healthcare across all sectors will be vitally important.


Case study: Derbyshire Health United (DHU) 

  • Operates as a not-for-profit social enterprise
  • Providers of out of hours, walk-in and urgent care services
  • Servicing contracted CCGs and over 300 GPs
  • Covering 1,000,000+ patients
  • Operating four walk-in centres
  • Call handling and triage expertise across wide areas of the East Midlands
  • Offers offender healthcare for police and prison services
  • Has developed the RightCare© scheme to ensure seamless care for patients out of hours
  • Any surplus funds generated are reinvested in staff and facilities so that patient services benefit

Derbyshire Health United website

Next: Essential components for collaboration