The NHS Five Year Forward View advocates primary care at scale, recognising its potential to bring significant benefits both to commissioners – in terms of the resilience and sustainability of primary care – and to individual GPs and their businesses
As part of our work with large groups of GPs, as they reassess their businesses and form larger partnerships and companies, we hosted a primary care round table discussion to explore some of the issues and consider the actions required to build sustainable primary care. This showed that:
- current arrangements for delivering primary care are unsustainable in the medium-term and GPs must focus on generating additional income or reducing expenditure
- reducing expenditure appears to be the most realistic option
- the main option available to increase income is to bid for CCG-led contracts to provide acute services
- in some areas, GPs also have the option of working for a local NHS trust as a salaried GP, reducing their exposure to financial risk; and enabling trusts to manage patient pathways more effectively
- it is in the long-term interest of CCGs to assist GPs move towards delivery of primary care at scale.
Both the round table and the case studies in our report illustrate the success of many of the existing initiatives to develop primary care at scale, and make it more sustainable and resilient. Our report also outlines practical ways in which GPs can generate additional income or reduce expenditure.