Transforming General Practice

Unlocking the Potential

Current Market Context

• 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

Traditional Practice Model Federations ‘Super Partnerships’

(Sole trader, multi-partners)

FullMerger/Integration

CollaborationConsultation

2k – 15k patients 30k – 500k patients 80k + patients

Emerging Models in General Practice

The Vitality Partnership

• 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 26k •2010 32k•2011 38k•2013 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

Partnership Structure

• Executive Partner• Medical Director

• 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

• 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

• Greater level of strategic discussions• Increased scope of topic feedback • Changes to practice information – pt led.• Prompt feedback on service change• Innovative surveys

Challenges

• 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)

• 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

• Community partnerships• Health and wellbeing services• Social Care• Mental health

Vitality Partnership

Innovative Organisational Dynamic