Viewpoint: Innovation and the independent contractor status of general practice

Dr David Geddes, head of primary care commissioning at NHS England, last week suggested that our independent contractor status was a bar to innovation. Well I agree, and I don't.

The fact that practices are small independent units means they can have a go at change and innovation in a way that big units can't do. They can match the specific needs of their populations in a way that works for them and their patients.

The fact that there are thousands of us means that dissemination of ideas and adoption is a difficult task.

So Dr Geddes, I get what you're saying but there are a principles we should apply to solve the innovation equation and some pitfalls we need to avoid.

We need to be able to create passion in our people to follow what matters
Search  for ‘Google nine innovation principles’ and you will see that to make it work we need to be alive to innovation from anywhere, not just top down diktats. We need to be able to create passion in our people to follow what matters. New NHS England chief executive Simon Stevens summed it up well last week: ‘Think like a patient, act like a taxpayer’. There's more: you gotta search engine, use it. I've only got a couple of hundred words.

So here's the rub, right now there's a lot of talk about vertigration, big providers are keen to run primary care, keen to deliver at scale but that's a real big innovation killer. Being the big incumbent provider in a virtual monopoly situation gives you no driver to change. Even when the world changes the big established players fail to adapt, the need to recreate themselves, it's an historical fact.

So it's a tough call. My best suggestion? Get over to your academic health science network. Pick its brains and innovate your pants off starting with your own practice.

  • Dr Chris Mimnagh is a GP and co-director of clincial strategy at Liverpool Health Partners.

Photo: UNP

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