Networks can revive the GP partnership model, say clinical directors

Primary care networks (PCNs) have the potential to breathe new life into the GP partnership model by reducing pressure on practices, according to GPs leading the organisations.

GP practice (Photo: mtreasure/Getty Images)
GP practice (Photo: mtreasure/Getty Images)

Some PCN clinical directors believe the networks' potential to bring in new staff to support primary care could begin to tackle the rising workload that has been a key factor in driving GPs out of partnership roles.

Stabilising the GP partnership model was at the top of a five-point list of targets set for PCNs by NHS England earlier this year - and some senior GPs have suggested it is simply unrealistic.

Clinical director of Bridlington PCN in Yorkshire Dr Zoe Norris, however, told GPonline that saving partnerships may be the most achievable of PCNs' five goals.

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Clinical director of Mendip PCN Dr Robert Weaver was similarly hopeful - pointing to pilots of similar models that found collaboration between practices and sharing of staff had helped boost retention of existing partners and to attract new ones.

In recent years, there has been a massive rise in GPs leaving partnership roles. Over the year from June 2018 to June 2019, the number of partners in England fell by 791 - a 3.6% reduction. More than 3,000 GPs have left partnership roles since September 2015.

GPs remaining in partnership roles have struggled to recruit and found their workload increasing. A GPonline survey last month found that full-time GP partners work 50% more than a standard 37.5-hour working week.

Dr Weaver said: ‘There was a pilot project in West Somerset where they did a similar thing to what PCNs are doing now and one of the positive outcomes was that it seemed to improve retention and attract more GPs.

Competition

‘This was because it started to look more attractive [to become a partner], with things like shared learning events and less competition between neighbouring practices. So, I think it could have a knock-on effect of making the area more appealing to work and settle down in.’

Dr Weaver said that sharing staff recruited with funding delivered through the network DES contract should boost collaboration, reduce competition and help partners to overcome recruitment problems.

'The other benefit for partners is that, because we are sharing extended hours, it may even be the reality that we are able to share [existing] staff within the network. If practices are really struggling because clinicians are on annual leave or off sick, GPs within the network could cross-cover.’

Dr Weaver added that practices working in a more aligned manner could find it easier to recruit locums, because locums would find it easier to switch between practices in the same area.

Locum GPs

‘I think this probably applies to salaried GPs and locums because it’s potentially easier for a locum to work in a network and there will be shared or similar ways of working in those practices. That could reduce pressure on partners - they might not necessarily be direct priorities for the network but it could be a secondary benefit.’

Dr Norris said that for PCNs, stabilising general practice as a whole was more important that any other individual target. But she argued that saving partnerships could be in their gift - and a key first step towards achieving their wider aims.

She said: ‘The only target that might be realistic is stabilising the partnership model, and I think until that is done, then you’re going to struggle to deliver any of the others.

‘I think it’s more about stabilising general practice as as whole; stopping practice closures, stopping practices feeling like they need to stop their lists and stopping contracts from being handed back and passed around several different providers.

‘It’s that aspect that, if PCNs can stop, and stay steady for the next two or three years, then you have a chance of achieving other things.'

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