GP Federations The “Shovel Ready” Approach to Primary Care Investment

The latest communication from the NHS to GP practices in England is helpful in many ways.  One aspect it stresses is a continuing emphasis on GP practices working together even more closely.  GP Federations can be a route towards that collaborative working, helping each other to face challenges and grasp opportunities.  The Prime Minister uses the phrase “shovel ready” to describe infrastructure projects that can be invested in quickly.  GP Feds can be one route for “shovel ready” investment in primary care.

Federations can provide a ready to go vehicle for joint activities.  The same is true of PCNs but the Feds allow things to happen at a bigger scale than PCNs and may be organisationally better equipped.  Our experience working with Feds is often of them working across several PCNs to provide support and services.  That is an effective way of having collaboration that works, creating scale in employing shared clinical staff for instance.

But the Federations need to be ready to step up to the plate.  That means having the capacity, capability and organisational resources to provide management and administrative support and clinical services.  That approach will allow PCNs to concentrate on designing the services that will meet the specific needs of their patient populations.

GP Federations vary in the scope of their activities and their organisational capacity.  If they wish to play a part in the provision of services at a greater scale there is a need for them to ensure that they have the organisational capacity and capability to take on services such as employing and deploying the additional resources pledged through the DESs for current and future years.  If the governance arrangements are not right, and often they are problematic, then there will be issues around the effective and equitable provision of services or, just as bad, perceptions of that.

Getting Feds into the shape that means that they can fulfill their potential can be a challenge.  If there is not effective day to day leadership with appropriate remits and the freedom to deliver on them it is unlikely to happen.  Got right it can provide a basis for proposing solutions to the local health economy and building capacity and service provision that is sustainable and well run.

At Scale’s development work with Federations has shown that they can be a major player in the new NHS landscape.  That will not be the case for all the new arrangements and will not be capable of application everywhere.  However, for well organised Federations the opportunities to make a big difference are apparent.  It is time to get these shovels out!