The BMA’s survey into the attitudes of GPs towards collaborative working bears out a very simple truth: federations and networks are not for all, but many GP practices are keen to look into their benefits. Unfortunately, it also reveals that significant barriers lie in front of GPs simply wanting to explore this option, not least finding the space, time and energy to do this when they are overwhelmed by the pressures of their day-to-day workload.
There is little doubt that many practices could be helped by reaching out to work with their neighbours, not least because of the huge pressures on general practice that recently lead the BMA to launch the 'Your GP Cares' campaign. General practice as a whole is being stretched to breaking point by rising patient demand, falling funding and a political drive to divert care from hospitals to community settings without at the same time transferring the resources to make delivery sustainable.
In this environment, it makes sense that we all look at ways we can pool our resources, cut down on duplication, develop better peer support and use team working to plan local services more effectively. It is therefore not surprising that a third of the respondents to the BMA survey of 1,500 GPs revealed they are involved in a practice considering joining a federation, while one in five are already part of this arrangement.
We should not, of course, think that greater networking is a magic "one-size-fits-all" model that will suit everyone or solve all our problems. Practices need to be both big and small: we must retain the essential elements of general practice that has made it so successful and popular with patients for decades, namely flexibility, being rooted in local communities, continuity of care and GPs having the autonomy to be advocates for their patients. However, for many practices there are clear advantages in pursuing a greater collaborative approach.
Practices held back
It is therefore depressing that the very reasons that are resulting in practices looking into federations and networks are also holding them back. Around seven out of 10 said they were either too busy or didn’t have enough time to properly consider greater collaborative working. The fact GPs in large numbers felt they need support on legal, HR and project management issues demonstrates that practices understand this is a complex undertaking, but don’t have the tools to allow them to tackle it.
This situation is another example of why the BMA launched the 'Your GP Cares' campaign. Here is clear evidence of GPs wanting to take up an innovative way of working, but being prevented from doing so because they are not being properly supported. This is why we need the long term, sustained solutions that we are calling for.
In the meantime, the BMA is going to take up this challenge. We already have excellent guidance on how practices can take forward greater networking and we are looking into what other services we can provide. Ultimately though, NHS England has got to start backing general practice with the tools that will enable them to work in ways that will help GPs overcome the rising demands facing the NHS.