Press Release

RCGP launches major new business model for the future of general practice

26.06.08

Politicians and doctors should be concentrating on the day to day needs of patients instead of arguing the pros and cons of buildings and real estate in the NHS review.

That is the message of the RCGP in its new publication demonstrating how GPs working in federations are the real solution to delivering improvements in patient care.

Primary Care Federations – putting patients first sets out an approach to the development of primary care that builds on and preserves the strengths of general practice and shows how services can be extended to meet the new challenges ahead.

The RCGP believes that federations are the key to delivering a whole raft of improvements for patients including better access, services closer to home and health promotion. It proposes groups of GP practices working in partnership to provide a wider range of services - including x-rays and scans - to patients in their local community.

One of the greatest single benefits of Primary Care Federations is that existing buildings would be used more effectively, rather than the Government investing money in the development of large new health centres.

Under the RCGP proposals, the savings created would then be ploughed into building up high quality practices so that they can develop and extend their services for patients.

The RCGP is growing increasingly concerned that in the battle of words between the Government and the BMA over GP access and Lord Darzi’s review of the NHS, the voice of the patient is being forgotten.

The new publication is the College’s attempt to refocus the debate and provide a workable solution that is acceptable to both sides and that, most importantly, provides the very best possible care for all NHS patients, regardless of their circumstances or where they live.

It demonstrates how GP practices can set up federations and how the model can be adapted to suit particular geographical circumstances and patient populations, providing real life examples of how different GP teams are already making federations work in practice.

Federations would have a number of key features including:

    * High calibre management that could develop the collective delivery of certain “back office” functions such as finance and human resources.
    * Capacity to increase number of internal referrals between clinicians within the federation as it began to use the diverse skills and interests of members more effectively - federations might choose to employ specialists such as dermatologists or specialist diabetes nurses.
    * Critical mass to ensure that different GPs could concentrate on different priorities and developing more effective services for promoting health and preventing ill-health.
    * Capacity to widen the range of primary care services by moving services from hospital settings and developing as many services as possible within the community including enhanced diagnostic services.

    * Capacity to improve the quality of patient care and patient safety by ensuring good governance across the organisation.  This governance function would include support for effective annual appraisals and revalidation for medical members and other staff.

RCGP Chairman Professor Steve Field said: “The Government and the BMA both have very valid, albeit opposing, viewpoints but we want to get the debate back to where it belongs - delivering better services for our patients.

“We believe the solution lies in creating Primary Care Federations with GPs and their teams working in collaboration and co-operation rather than competition.

 “It’s time for the profession and the Government to embrace a new way of working.  The traditional small business model of general practice is unsustainable in the long term but in seeking to replace it we must not throw out the baby with the bath water.

“GPs are good at adapting to change and seizing opportunities for improvement.  We can achieve more through GP practices working together than by individual practices working in isolation.”

The RCGP Roadmap published in September 2007 – before Lord Darzi’s review - introduced the concept of Primary Care Federations with practices working to share resources, expertise and services.

The subsequent announcement of Lord Darzi’s review included the recommendation that a network of large health centres – now commonly referred to as polyclinics - be established in particular areas of the country including London to provide up to 50% of outpatient treatment currently carried out in hospitals.

While the Government has insisted that the health centres represent new and additional capacity, the BMA has vigorously opposed the concept, claiming the new centres threaten the existence of some local GP surgeries.