Nick Goodwin said if GP-led commissioning is to deliver what the government demands then it is ‘almost certain' that larger units will have to be created.
‘The scale will be different in different places. But the agenda is not going to be a return to small-scale fundholding,' he said. ‘In order to deal with the whole or most of the budget and tackle the issues, the scale of commissioning groups needs to more substantial than in the case of fundholding.'
Mr Goodwin said improving care will require ‘more networked, integrated and joined-up solutions,' which do not undermine the value of general practice.
He said: ‘This is about reducing isolation and getting GPs to work in partnership with their colleagues. This is the next step forward for general practice.'
Mr Goodwin said the inquiry, due to conclude later this year, will offer recommendations about how to assess quality in general practice.
He said general practice was undergoing a ‘quality revolution that is likely to significantly challenge and change the nature of its work'.
He said a ‘more intelligent approach' to measuring quality is needed, as measures such as QOF do not ‘capture the true essence of care quality'.
The King's Fund has launched an online page aimed at allowing the profession to inform the inquiry into general practice.
Editors' blog: Abolishing practice boundaries to create HMOs