GP practice silos 'stifle innovation'

Innovation in primary care has been held back because there are too many small GP practices in England working in 'silos', a senior NHS England official has claimed.

Dr Geddes: practices must be supported to share ideas (Photo: UNP)
Dr Geddes: practices must be supported to share ideas (Photo: UNP)

North Yorkshire GP Dr David Geddes, head of primary care commissioning, said that practices may need to federate to provide certain services in the face of rising demand.

He added: ‘If we were to start with a blank piece of paper, would we have the 8,080 practices that we have in England? Probably not. Probably, that’s one of the most effective ways of stopping innovation spreading across the country.’

Dr Geddes said that practices often failed to share their innovative ideas with other parts of the country. NHS England must support GPs to work together more often and to share best practice, he added.

However, the GPC said ‘unsustainable’ demands on GP workload must be tackled first, before different ways of working can be discussed.

In a speech to the NICE annual conference in Birmingham last week, Dr Geddes acknowledged the challenge of innovating at a time when many GPs were feeling ‘burnt out’ and were struggling with capacity. He said more needed to be done to ‘help support some of the innovative ideas that go on in primary care and help them spread’.

NHS England needs to commission healthcare in a way that helps GPs share ideas and ‘raise their heads above the day-to-day grind’ to work differently, he said.

Sharing ideas
Speaking to GP, Dr Geddes said there were ‘quite a lot of silos’ in primary care, and that commissioners were key to improving idea sharing. 

‘CCGs and [NHS England] area teams have a vested interest in supporting development on how to do things differently,’ he said.

GPC deputy chairman Dr Richard Vautrey said the GPC welcomed discussions about how primary care could work differently to improve care. But he said GPs first needed the  time and space to do so. 

‘The current unsustainable workload GPs are coping with needs to be addressed, which has been made worse following the recent disastrous contract imposition,’ he said.

‘One of general practice’s great strengths has been its ability to innovate and adapt quickly to changing circumstances, and that is because of the control and incentives the independent contractor model gives practices,’ Dr Vautrey added.

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