Who will take the opportunity to reshape primary care?

The success and high reputation of British primary care has meant it has largely avoided reformers’ attention. There have been myriad contract reforms, but little challenge to its fundamental model of operation.

‘The GP profession is placing much faith in the federated practice model, but its impact is limited’

That may be beginning to change. There is recognition the shift to delivering more care in the community will not be achieved without significant involvement of GPs and that they provide the best foundation on which to build.

This week’s King’s Fund report on the future of primary care is garnering significant attention in government, while on the other side of the political divide Andy Burnham has signalled he is “prepared to look at… the old independent contractor model for GPs, and whether it creates an unhelpful divide that becomes a barrier to integration”.

Untangling the knot

But will the majority of GPs wish to grasp this opportunity to take on greater responsibility for care? The profession is placing much faith in the federated practice model, but its impact is limited.

‘As commissioners develop contracts to pay for the overall care of a population, it is these organisations that will be among those best placed to secure them’

HSJ’s unique analysis of the primary care sector shows those organisations making the clearest progress in developing the general practice provider model are standalone companies or partnerships led by GPs.

As commissioners develop contracts to pay for the overall care of a population, it is these organisations that will be among those best placed to secure them. King’s Fund chief executive Chris Ham says if GPs do not choose to take on these new contracts “then NHS trusts should be given the opportunity to do so”.

He also adds, “GPs are both providers and commissioners of care, [but] their role as providers is the more important of the two.” This will ring true with many and highlights the challenge facing policymakers required to unpick the Gordian knot created by the reforms of the last few years.