GP federations must fit patients' needs

A CCG lay member has warned that GP federations will only work if built around the interests of patients rather than 'internal concerns'.

RCGP HQ: venue for federations conference
RCGP HQ: venue for federations conference

Speaking at a conference at the RCGP’s headquarters in London, Newham CCG vice chair and lay member for patient engagement, Wayne Farah, said the success of federations depended on their ethos around patient engagement, not on structures and processes.

Mr Farah, whose CCG helped organised the conference, described how when Newham GPs first outlined plans for federating, his response was, ‘not another reorganisation’.

‘It seems as though the NHS is consumed with reorganisation,' he said. ‘And often it feels like we are rearranging the deck chairs on the NHS Titanic.’

But he praised GPs from the Newham First4Health federation, which GP reported exclusively on last week, for their commitment to patient engagement.

Patients, he said, were also positive about the federation because of the offer of better access to core services, specialised services closer to home, and wider choice of specialist services. But patients also feared the risk of damage to the personal relationship with their GP and continuity of care, as well as risks to confidentiality and access to patient records.

Mr Farah said the key question was whether GPs’ plans meet the ‘patient test’. 

‘How far is what you are doing about the needs of the patients, and how far is it about your own, internal concerns?’, he asked.

GPs should take a ‘radical approach’, he said, to build active partnerships with patients and the community in order to build successful federations.

Mr Farah stressed the importance of engaging with ‘traditionally excluded’ groups from the ‘margins’ of communities whose voices were often drowned out by the ‘articulate middle class’.

Federations, he added, must build ‘new structures of accountability that give patients shared ownership of the organisation’.

‘No longer a couple of token patient reps who are easily marginalised and kept outside whenever there are important decisions to be made,' he said. 'But actual representatives from the community and from the patients, who have a power base within the patient body and are accountable to your patients.

'And have the resources and capacity to get in the expertise they need to support them to articulate their voices around the table with all the experts. And that does mean investing in your patient reps.’

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