Learning about and learning from GP Federations in the English NHS a qualitative investigation

McDonald R, Riste L, Bailey S, Bradley F, Hammond J, Spooner S, Elvey R, Checkland K
Record ID 32016001080
Authors' objectives: What we know: GP federations, defined as groups of practices and primary care teams working together, sharing responsibility for developing and delivering high quality, patient focussed services for their local communities (RCGP Toolkit 2010) are emerging in response to the pressures facing primary care(Kings Fund, 2013: 5). There are various ways in which practices might work together and these can range from from loose alliances of a small number of local practices, to much larger publicly limited provider companies. Potential benefits include more 'joined up' working and improved service provision, as well as cost savings. There are risks, however, which include a 'one size fits all' approach to care delivery and a loss of local freedom for GPs. What we don't know: Little is known about the number of federations across England. We know very little about how each of the different federations is organised, what their aims are and the impact on staff and patients. We also don't know how working in or being a patient in a federation compares with non-federation settings. What we aim to produce: Our aims are To provide a wide ranging and in depth exploration of GP federations in England To strengthen the evidence base on the organisation and management of general practice for the twenty first century How we will do this: We will build on work that is being undertaken in 2 counties (Notts & Derbys.) where a picture of the number and type of federations is being captured, as well as our local knowledge of federations in Greater Manchester to construct a national picture of the number of federations. We will classify these into federation types. We will then use this to choose 3 federations which have different forms, as case study sites. We will also choose 1 non-Federation site. We will follow what happens at these sites over a period of 15 months. We will interview patients, carers and staff who are involved in these sites. We will also interview staff from local hospitals and community health services as well as relevant local authority staff. We will also observe relevant meetings and examine documents to obtain as complete a picture as possible of what is happening in each of the sites. We will not measure performance of federations across the country, but we will examine the declared aims of each of the 3 federations in our study and assess the extent to which these have been achieved. We will also look at the assumptions amongst the people leading the federations about how they are supposed to be working to produce the expected benefits. We will not use large surveys as we think (based on what we know) that this will not give a high response. We will not try to quantify the impact as we need to know more about how and why things are happening before we can try to do this at some point in the future. We will not try to cover a large number of organisations because that would mean spreading ourselves too thinly.
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Community Networks
  • Learning
  • State Medicine
  • General Practitioners
  • Cooperative Behavior
  • General Practice
  • Quality of Health Care
  • Primary Health Care
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
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