GP practices could merge into 1,500 'super hubs' under NHS reforms

Thousands of GP practices across England could be closed as general practice provision shifts into 1,500 super hubs delivering care for populations of around 40,000 patients, a health minister has suggested.

Around 7,500 GP practices across England currently care for average populations of around 7,000 patients, but the switch to larger units could come through a gradual migration in coming years, health minister David Mowat told MPs on Wednesday.

Comments from the minister came in a House of Commons debate on soaring indemnity costs for GPs, in which Mr Mowat pledged that financial support to protect the profession from the impact of higher fees would extend beyond the current £60m package agreed for 2016/17 and 2017/18.

General practice could move over time to a system where there are just 1,500 large ‘super practices’ providing care at scale, Mr Mowat told MPs.

Government plans to see more super practices - or hubs that bring multiple existing practices together - emerge across the country could see the number of practices overall reduced to just a fifth of the current number, according to the health minister.

General practice at scale

He told MPs: ‘Increasingly across the country, we’re finding that it’s working better by putting GP practices into hubs of 35,000-40,000 people. They're able to do more things at scale than perhaps they’d be able to do as smaller practices.

‘We’re migrating over a period of time to a position in which – there are 7,500 GP practices around the country – to something more like 1,500 of these super hubs. But the contract position hasn’t caught up with that, and that’s a long road.’

Mr Mowat welcomed the rise of ‘super practices’ in Dudley, which have ‘possibly 100s’ of GPs working in them to provide care over large areas. 

‘There are super practices emerging of 10s of GPs – possibly 100s – of GPs who can provide services across much wider areas,’ he said.

‘That is a difference in model and there's some evidence that it’s enabling those practices to offer more career structures to those GP s and the opportunities to specialties they didn’t have before.’

GP premises

A DH spokesman told GPonline that it was not the government's aim to close practices as part of the transition to providing general practice around populations of 40,000 patients. In many cases general practice could be grouped at this scale through collaboration, he said.

Although in some areas 'superhubs' could be formed virtually through collaboration between existing practices from their current premises, some sustainability and transformation plans (STPs) published to date have set out plans to co-locate practices - moving them to new locations, with existing premises shut down.

GPonline reported in December on plans in Dorset that could lead to a 70% reduction in GP practice sites across the county.

In Newcastle, talks are underway over plans to co-locate multiple practices in new premises with financial support from a local council.

The DH spokesman said it was becoming 'increasingly normal' for practices to work together, with more than half of practices now in federations or networks. He pointed to GP Forward View pledges to give practices more opportunities in future to work in larger groups but 'maintain their unique identity and relationship with their own patients'.

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