Welcome to our new Partners … why have they joined at this time.
We are pleased that from 1st May 2017 8 new practices have joined Our Health Partnership, including 6 practices from Shropshire. This makes our total numbers within our partnership 39 practices with 187 partners – we welcome all of the partners. Our expansion provides the opportunity to consider what it is that compels practices to start the journey of joining an at-scale GP organisation, to choose to invest resources in the joining process and to choose to join OHP in particular. Why now? Why OHP?
Perhaps OHP have been shy of selling ourselves in the past, for fear of seeming predatory or arrogant. OHP was conceived and has grown, so far, mostly through word of mouth. As we consider actively making offers to practices and groups of practices understanding the driving forces behind collaborative working is important.
One could argue that the drive for GP practices to collaborate is simply an economic squeeze on primary care that has seen our share of NHS resources shrink in recent years in the face of rising demand from patients, secondary care and NHS England. One could argue that collaboration is tantamount to colluding with under-resourcing, however, in a pragmatic sense the only extra funding that GPs will receive in the foreseeable future will be attached to schemes that are dependent on working as part of collaborative organisations. Extra funding is a vital part of the puzzle to solving the sustainability conundrum in primary care and the only way that general practice can begin to tackle the issues of workload and workforce.
As with skinning a cat, there are many ways to collaborate. At one end of the spectrum there are federations which connect practices through a separate legal entity, such as a limited company, which at the moment can carry out non-core contract work and may be able to share “back-office” functions. At the other end of the collaboration spectrum are fully merged super-practices, with a one size-, one approach-fits all methodology which inevitably leads to a loss of identity and autonomy. One could argue that the there is a greater degree of safety in super-practices in spreading risk over a larger number of partners at the cost of independence. It is worth noting that historically many collaborative organisations and super-practices have been reliant on non-recurrent funding for pilot schemes, vanguards and innovative work.
Our Health Partnership offers a “middle way”. We would describe ourselves as a super-partnership, a partnership of partnerships. An over-arching partnership deed binds together upwards of 40 independent practices, enabling them to retain a large part of the individual autonomy to operate as local surgeries, serving the needs of their local populations. The deed requires a commitment to various aspects of the running of the practice. In return for an annual subscription that funds the financial and corporate infrastructure in a way that is not reliant on external funding, but has great potential to secure it, there are tangible benefits to being part of a larger organisation, which are also listed elsewhere on our website
Each individual partner of each practice will undoubtedly have a slightly different mix of reasons for joining or being part of the formation of Our Health Partnership, ranging from the opportunity to influence national general practice healthcare policy to the ability to retain independent contractor status within a sustainable, effective partnership model. Being part of a larger organisation enables our GPs to have a voice with their CCG and STP organisations as well as the financial benefits of economies of scale and clinical advantages of sharing best practice whilst retaining autonomy in running local practices to suit the particular needs of their teams and patient communities.
OHP has already employed a centrally funded salaried doctor and is expanding this, as well as securing funding for being part of the GP Career Plus pilot, in addition we have committed to collaboration with Birmingham Cross City CCG in an NHS England-funded scheme to recruit additional GPs from abroad, thereby having a positive effect on workforce retention and recruitment.
No-one can predict the future. Indeed, at the time of writing the political landscape of the UK seems particularly volatile and uncertain. A period of austerity has led to investment in the NHS not keeping pace with demand, including in general practice. If they are to be believed the plans in place for the NHS do include investment in primary care associated with restructuring of the way care is delivered to patients. To access that investment GPs will need to be part of a collaborative group, to have a say in how care is restructured, we will need to speak with unity. OHP offers the opportunity of security, long-term sustainability and representation whilst retaining many of the aspects of general practice autonomy and independence that made it so attractive to many of us in the first place.
Samir Dawlatly is a GP partner at Jiggins Lane Medical Centre and Board Member of Our Health Partnership. The views expressed here are his own and don’t necessarily represent that of any organisation he works for.