Editorial - Bigger does not always mean more beautiful

This week GP reveals exclusively that twice as many GP contracts are now ending per year as two years ago, according to PCT figures. Mergers accounted for 49%, PCT terminations 20% and retirements 14%.

The current climate of imminent Care Quality Commission practice registration, revalidation implementation and the threat to pensions is likely to be playing a part in GPs' decisions to retire.

Last month, a Leicester University study found that allowing a patient to see a particular GP in a surgery had an important impact on reducing hospital admissions. Researchers found a 1% increase in the proportion of patients able to see a particular GP was associated with a reduction of 7.6 elective admissions per year in the average sized practice in one year and 3.1 in another.

It doesn't sound like rocket science but it does appear that continuity of care works.

It is this continuity of care that is under threat in the current climate of practice mergers. GPC negotiator Dr Peter Holden criticises the government for its opposition to singlehanded GPs. 'It believes big is beautiful, it thinks in economies of scale.'

It is exactly this view that makes it more difficult for singlehanders to gain premises funding from PCTs.

Government, the DH and PCTs are not alone in perpetuating this view. The NHS Commissioning Board (NCB) has also overseen the end of the authorisation dream of England's smallest clinical commissioning group (CCG).

The Red House Group CCG, covering 18,900 patients in Hertfordshire, formed because it believed its size made it better able to respond to its patients' needs.

We'll never know whether it would have been successful or not. The NCB, already facing accusations that it is exerting too much central control, would have perhaps been wiser not to assume that bigger is always more beautiful.

Continuity of care is the jewel in the crown of general practice and should be something to treasure rather than discard.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Practices handed one-month opt-out window as revamped network DES unveiled

Practices handed one-month opt-out window as revamped network DES unveiled

NHS England has unveiled a revamped DES package for 2020/21 confirming new targets,...

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered huge rise in face-to-face consultations in week before NHS England letter

GPs delivered a huge increase in face-to-face appointments in the week before NHS...

RCGP facing legal action over stance on assisted dying

RCGP facing legal action over stance on assisted dying

The RCGP is facing legal action over its decision to remain opposed to assisted dying...

Medeconomics Live aims to help practices thrive under the new GP contract

Medeconomics Live aims to help practices thrive under the new GP contract

The one-day, virtual Medeconomics Live conference aims to provide practices with...

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GPs face wave of abuse and complaints after NHS England face-to-face appointments claims

GP practices have faced a wave of abuse and complaints after a letter from NHS England...

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

Government denies plan to make GPs 'gatekeepers' of COVID-19 testing

The government has denied plans to make GPs 'gatekeepers' of the struggling COVID-19...