1. RCGP-Nuffield General Practice At-Scale Programme
Dr Mike Holmes, RCGP Clinical Lead Dr Rebecca Rosen, Senior Clinical Fellow, Nuffield Trust
#GPatScale

2. Drivers of at-scale collaboration
Reduced funding
Large scale general practice organisation
Reduced funding
New funding for large scale GP providers (eg GP Access Fund)
Threat from alternative GP contracts
Threat from alternative GP contracts
CCG prime and alliance contracts
Rising patient demand
Rising patient demand
Rising administrative demands
New contracts for extended services
Push factors
Historic relationship between practices
Pull factors
Rising administrative / regulatory demands
Alternative GP contracts
Policy on extended and seven day access
Local history and context:
GP Fundholding
Practice-based commissioning
Delivering community services
Policy on extended and seven day access
Potential funding for large scale GP providers via STPs
Workforce shortages
Workforce shortages
#GPatScale

3. Large-scale brings opportunities
Staff were broadly positive about working in a large-scale organisation
They valued education and training opportunities and peer support arrangements across practice boundaries
Larger scale can improve sustainability through operational efficiency, technology and enhancing the workforce
But significant resources are needed to develop and maintain new initiatives
Patients had mixed views about large-scale general practice
They identified more with their own practice than with the overarching organisation and worried about losing continuity
Source: Rosen et al 2016 Is Bigger Better: Lessons for Large Scale General Practice 

4. Understand GP collaborations
Our support offer
RCGP-Nuffield General Practice At-Scale Network aims to:
Survey RCGP (2015 and 2017)
Examine case studies of success
Understand GP collaborations
Consolidate evidence
Facilitate expert advice
Support practices

5. GP At Scale Programme

6. What Next?

7. We want to hear from you
What are your experiences of working at scale?
How can we best support you?
What else can we do to facilitate this agenda?
How can we grow the network?

8. Thank you