Can we deliver Enid-shaped care if we move to working in larger organisations?

October 23 2017
Michael Mulholland

Michael Mulholland
GP Partner, Princes Risborough Surgery
RCGP Ambassador
RCGP clinical support fellow, General Practice At Scale programme

The RCGP annual conference in Liverpool last week led to headlines about the Secretary of State, indemnity and workforce, however it will have been RCGP Chair Helen Stokes Lampard’s reminder of the importance of ‘Enid-shaped’ person centred care that many will have brought back to practice with them.

GP at Scale was also on many people’s conference agenda from the formal presentations on Quality at Scale and Super Practices to the conversations around the launch of the Nuffield Trust and RCGP survey – “Collaboration in general practice” – which highlighted that 81% of GP respondents now work in often multiple formal or informal collaborations which often fulfill different purposes.

The survey found that collaborations were forming most often to increase access for patients, improve sustainability and shift services into the community – themes that reflect the stories shared in the presentations from the Superpartnerships and within Buckinghamshire’s ACS. As our first poll on the learning network also showed, GPs are unwilling to give up their current contracts to work at scale, the most common reason being the risk of loss of control over decision-making and leadership in their practice.

I was left wondering, following the many conversations I had in Liverpool with GPs already collaborating at scale, whether, instead of a reluctance to lose control or leadership, some of the anxieties are based around whether we can continue to provide continuity and deliver Enid-shaped care if we move to working in larger organisations?

Perhaps it will be only when we hear and see how new models of care at scale can and do enable GPs to deliver the person-centred care that we and our patients value in their local setting that those fears will be allayed. So please do log on to the network ( and share the experiences, successes and challenges you are facing as you try to design new systems of care with continuity and patient-centredness at the core.

Presentations from the conference and our recent events in will soon be on the network too so please have a look and share your stories.

We are continuing to try and make the network more accessible – have a look at the link you can add to your mobile device’s home screen that will make the connection more straightforward and please share any feedback you have about this.

Our next meeting is the national event in London where we hope to have representation from all the main National Organisations involved in the development of GP at scale. You can view the agenda and register for free now to attend this event.

Finally, please do share your experiences of working at scale as well as any ideas for future poll question, discussions, or activities with the network or directly with me ( to help us develop a real learning resource for those GPs wanting to learn more or work at scale.


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