Are federations in search of a purpose?

December 18 2017

The RCGP GP at Scale National Conference in London earlier this month started with the question “are federations in search of a purpose?”  Mayur Lakhani President RCGP suggested that organisations should look at Barbara Starfield’s four pillars of primary care – first Contact accessibility, Coordination, Comprehensiveness, and Continuity as their benchmark when defining that purpose.

During the day we heard from organisations around the country including Sunderland Alliance, Symphony from Yeovil, and Beacon Medical practice from Devon who each described how their organisations were starting to deliver the quality care that Starfield described. This was being achieved through changes to organisational structures that reduced the divide between primary and secondary care, new roles such as the Extensivist role for clinicians in the Symphony group and new ways of working across multiple sites that brought new services and money to primary care.

It was clear by the end of the day, having also considered with NHS collaborate some of the leadership challenges of GP at scale, that there is no single model that can be implemented throughout the country each organisation must evolve to meet the needs of its local population.

As primary care physicians we know our own communities well and live daily with the tension between providing continuity of care and meeting the accessibility they need, whilst working in practices stretched by workforce challenges and rising demand.

It seems essential therefore that for GP at Scale to develop in any area, organisations will need good data on the health needs of their local population upon which to base any new care models, as the Nuffield Trust projects are demonstrating – including in the Valentine medical group. This will mean that working at scale can improve the care patients receive without increasing the burden on primary care professionals.

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