Super practices offer route to sustainability

12 December 2018

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In GP super practices: a prescription for sustainability in primary care, business and financial adviser Grant Thornton argued there is a pressing need for change away from the traditional small general practice blueprint. Bigger practices – formed by merging existing practices – would help primary care adapt to the new models of care expected to be outlined in the forthcoming long-term plan for the NHS.stocks l

There were questions about the sustainability of the current model, it said. Practices are facing severe funding pressures and rising costs, such as for locum GPs. With the move to tendering locally enhanced services, it was becoming more challenging to secure vital additional income.

Staffing is also an issue. The report said 37% of GPs in England are over 50 and, with the average retirement age 57, these doctors could retire in the next five to seven years. In many areas, between a fifth and a quarter of GPs are over 55.

Demand is also rising – the ageing population, coupled with greater longevity, means more patients on GP lists and more living with chronic conditions.

The firm insisted many traditional general practices will become unviable, leading to disrupted patient care; costly intervention to provide alternative primary care; and a likely adverse impact on A&E attendances and hospital admissions.

Super practices would vary in size according to local needs, but they would bring economies of scale, providing potential savings in administration and locum costs, medical insurance and professional fees – such as accountancy. While larger practices should gain greater operational efficiency, a better working environment and opportunities for greater specialisation should boost recruitment and retention of staff.

In a blog on the report, Grant Thornton head of public healthcare Mark Stocks (pictured) said: ‘Setting up a GP super practice is one approach for commissioners to consider to ensure long-term sustainability of primary care in their communities. While there are a number of alternative models available, such as vertical integration with hospitals, the advantages of merging with another practice is that they are obviously very similar organisations – with the same purpose of treating patients in their local environments.

‘They also tend to have similar operating models and the same regulators, income sources and cost bases. All of this makes it easier to set up a merger and make it work.’