Transforming General Practice
Unlocking the Potential
Current Market Context
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Increased demand for primary care
GP contract – doing more for less
CQC and new QoF - ‘demonstrating quality’
CCG developments and pressures on
commissioners
• Shift of focus of care from secondary to primary
• Greater cooperation with social care
• GP demographics
Emerging Models in General Practice
Consultation
Traditional Practice Model
Collaboration
Federations
Full
Merger/Integration
‘Super Partnerships’
(Sole trader, multi-partners)
2k – 15k patients
30k – 500k patients
80k + patients
The Vitality Partnership
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Built on local general practice with local GPs
Single partnership
Delivery at scale: 50k + patients
Clinically and quality focused
Commercial structure
The Numbers…
List size:
•2009
•2010
•2011
•2013
26k
32k
38k
50k
(LCG 125k, CCG, 550k)
• 15 equity partners
+ 3 fixed share partners
• PMS and GMS contracts
• £10m+ turnover
• 200+ staff
• NHS specialist services
• Private services
• 7 primary care sites (plus
university sites)
Corporate Overview
Partners
Salaried
Partners
Associate GP
Salaried GP
Partnership Structure
• Executive Partner
• Medical Director
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PPI lead
HR and workforce
Estates
Commissioning
• Director of Primary
Care
• Director of Specialist
Services
• Outlet Directors
• Comms and
marketing
• IT and informatics
• Teaching/Training
Organisational advantages
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Deliver Services at scale
Long term planning and investments
Greater ability to bid for AQP
In house business development
Greater level of local influence
Staff employment protection and development
Multi -sites – patient choice
Standardised policies and procedures
Clinical Quality
• Increase in overall quality in merging practices
(QOF points increase, access increase, range of
services)
• Increased uptake of flu vacs, cytology etc.
• Reduction in OPD referrals in merged practices
• Integrated care pathways
• Single patient record (EMIS web)
• Peer review of referrals and prescribing
Patient Engagement
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Greater level of strategic discussions
Increased scope of topic feedback
Changes to practice information – pt led.
Prompt feedback on service change
Innovative surveys
Challenges
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Clinical time investment into merged practices
Financial investment
Culture change – partners and staff
Communications – vision and decisions
Local GP politics
NHS in transition (PCTs/NCB/CCGs)
Accurate data to enable service planning and
evaluation
• Optimum size? How much risk?
Challenges (2)
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Lead and manage merger and acquisitions
Strategic business and investment planning
Organisational development
Property and estates support
Legal, accountancy, financial management and
HR support
• New business and market opportunities
Our Vertical Integration
•Rheumatology
•Dermatology
•Orthopaedics
•Immunology
•Substance Misuse
•X-ray
•Intermediate Care
•ENT
•Urology
•Paediatrics
•Neurology
•Pain Management
•Gynaecology
Our Horizontal Integration
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Community partnerships
Health and wellbeing services
Social Care
Mental health
Innovative
Organisational
Dynamic
Vitality Partnership