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)

Full

Merger/Integration Collaboration Consultation

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)

Partners

Salaried Partners

Associate GP

Salaried GP

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