A total of 35 GP practices serving more than 270,000 patients across two Birmingham CCGs this week signed partnership deeds to form a single organisation.
The super-practice, called Our Health Partnership, will hold elections to appoint a seven-strong board of GP partners from the constituent practices.
Practices ranging in size from 1,500 patients to 26,000 have joined, and each will continue to operate under their existing contracts - the vast majority of which are GMS, with a handful of APMS deals.
The new partnership hopes to improve GP recruitment and retention and preserve existing practices while positioning itself to bid for more work and to adapt to emerging new models of care.
Interim chair of the group, Dr Vish Ratnasuriya, told GPonline the organisation had built itself on a model common among accountancy and legal firms.
'This is a single partnership,' he said. 'We are a single organisation. Each constituent practice is responsible for running its own affairs. Each practice, as part of the retention of autonomy, will hold their own contract on trust for the wider partnership. Each will be a registered site with CQC, and will still be inspected.'
Linking up was not done because member practices were struggling, Dr Ratnasuriya said. 'More than 30 relatively strong and successful practices have got together - all thriving businesses - we want to strengthen.'
He said initially the group would aim to cut bureaucracy by centralising back-office tasks, centralising CQC policies and appointing a single accountancy firm.
Practices spend a huge amount of time tracking and chasing payments, Dr Ranasuriya said - not only from NHS England, but also payments for teaching or training roles. 'It's the bane of practices' life and it is much more efficient to do this at the centre, with one person tracking payments on behalf of all practices - at the moment there are 30 or 40 practice managers doing the same work.'
The partnership hopes to set up a pool of salaried GPs - with the option to develop a varied portfolio career within the group - as part of a drive to create a sustainable workforce model for all primary care staff.
Dr Ratnasuriya told GPonline that the many training practices in the area often saw excellent trainees emerge with no jobs to go to, and the salaried pool could offer this group more options. Older GPs who have set a retirement date were also attracted to this option, he said, callilng it a 'powerful retention tool'.
'We have also identified that we spend a lot on locums,' he added. 'This is a way to address that and quality assure.'
Over time the group will aim to bid for a wider range of enhanced services, and could look to develop into the multispecialty community provider (MCP) model defined in NHS England's Five Year Forward View, although Dr Ratnasuriya said this was 'a long way off'.
Asked if the super-partnership model could help to redress the power balance between primary and acute care, he said: 'We are focusing on the here and now, but it could do. It gives us possibilities, and that is a great thing.'