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What does it mean to work at scale in general practice?

Sunday 4th Mar 2018 - Thornfields

The constantly shifting landscape of general practice and the wider NHS can present significant challenges, all against a backdrop of rising demand and diminishing resources. However, it also presents opportunities to introduce new ways of working and develop services with the aim of improving patient care, such as 'Working at Scale'.


We’ve recently seen a continuous trend towards policies based on ‘At Scale’ provision of care, which will see an increasing number of practices move towards collaborative working models. One of the key advantages of this approach is the ability to build on the strengths of practices and share the workload. But what is 'Working at Scale'?


Broadly speaking, working at scale means finding new ways of working that will enable you to meet the increasing challenges and demands placed on your business. Working collaboratively with other practices and healthcare providers within the NHS has emerged as a key element of this for general practice.
It’s clear there’s a desire within the NHS to increase the number of large-scale primary care organisations that can cover much bigger population groups than the traditional small-scale model of general practice. Initiatives like the Five Year Forward View in England and the drive to create GP Clusters in Wales and Scotland make that much clear.


There are a number of models of working that will support general practice work ‘at scale’, for example GP Federations and Multi-Specialty Community Providers (MCPs).

GP Federations and Multi-Speciality Community Providers


Federations are practices working together to deliver patient-focused services. Benefits include:


• Allowing practices to share resources, expertise and services.
• Forming an entity that can tender for services.
• Improving integration of services across practices and other providers.


MCPs help to support new models of care. They promote:


• Integration across the healthcare services.
• Redesigning care around the needs of the population.
• Prevention - reducing avoidable hospital admissions.


Different solutions will suit different practices and the people who work within them – so it’s crucial to be aware of the possibilities and opportunities that are available.


Some important things to consider include who you could collaborate with, how the change could affect your practice’s identity and what the practicalities of merging would be for administrative ‘back-office’ functions.


If you’d like to find out more about these topics, get in touch with our primary care training specialists to learn more about our course Working at Scale: GP Federations and the Multi-Specialty Community Provider.


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