Does working at scale mean ‘big money, big carparks, big distances’?

October 6 2017
Michael Mulholland

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

As we start the first of a regular GP at scale blog for the online learning network, it’s been a week in which I noted that the chief inspector of GP suggested ‘Scaled up GP does not necessarily lead to better quality of care’. On social media too it was suggested primary care at scale meant ‘big money big carparks big distances’ so it seemed appropriate to start a discussion to hear about what quality at scale means to you as someone working at scale and in your organisation.

Is it about better care for individuals, a measure of clinical competence, our professional behaviour or our responsibility to the wider environment, including the planning delivery and evaluation of local health and social all themes described in the RCGP position statement on quality in primary care? Or is it something else?

The position statement is clear “it is not possible in the real world to achieve excellence on all of these dimensions all of the time” so what is the current priority for you and your organisation?

There is no right answer to this but we all can learn from what others are doing and why that is your current focus, so please do log in and share.

Other activities you might have seen from the at scale team include the three recent webinars, the at scale event in Norwich and Newcastle at which lots of ideas were shared. The next event is in Bristol on 23rd October and you can register to attend now – attendance is free. Our first poll is now also live on the homepage of the online learning network.

Details of our national event on the 6th of December in London are coming together at which 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 to attend this event now.

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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