1. East Norfolk Medical Practice Merger of 3 practices in Great Yarmouth 2013 Jonathan Knights – Managing Partner Karen Mitchell – GP Partner

2. Where we were 2 GMS – 8,500pts between them struggling with recruitment, financial pressures 1 PMS – 12,200pts 2 sites successful, profits consistently increasing over 5 years

3. Why? GP Recruitment Reducing income/ increased demand Private providers Opportunity for more services to patients Opportunity to diversify and increase non NHS income

4. Why? To maintain traditional general practice on a financially viable scale

5. Where we are now 5 new GPs recruited Improved profitability/ income maintained GPs feel supported and can pursue individual interests Personal continuity of care with improved access Traditional general practice maintained

6. Considerations How long will it take? How much will it cost? How will we form – merger/take over? How will we work together?

7. The “little” things! Due diligence Legals TUPE Redundancies Contracts Premises/ property ownership Asset valuations + contributions

8. The “big” things! New identity People Culture Leadership Pace New ways of working

9. Next steps Your next steps? Merger, restructure, business redesign, do nothing Our next step was: Winners of RCGP Practice Team of the Year Birth of GP Business Support to assist with: Mergers, restructure, cultural change, change management, business redesign, training etc. Contact: jonathanknights@nhs.net