At scale GP collaboration

When Suffolk GP Federation was set up, one of our three aims was to support general practice at scale. Five years later it is interesting to note this aim is becoming mainstream.

As practice groupings emerge, often in response to the £3 per patient payment from CCGs, questions have been asked about how the Federation supports them. I thought it would be helpful to outline a few principles that the Federation is applying:

1. The Federation supports all models of collaborative working. Including small groupings of practices collaborating, through to integrated super-partnerships.
2. The Federation supports all collaborations of member practices equally. We are happy to use our knowledge, expertise and personnel to help practices work together. We have experience of innovative change and setting up new services.
3. Involvement of the Fed CEO. David Pannell, Federation CEO, is on the executive of the Suffolk Primary Care super-partnership and is also happy to bring his experience to other groups.
4. Sharing initiatives. Where the Federation works up an initiative we will offer these services across all groups. Examples include working at scale using pharmacists and physios, the introduction of a quality dashboard and use of DATIX (a significant event software system). The Fed website also includes details of the practicalities of introducing an on the day team or domiciliary care team.
5. Transparency. Minutes of meetings between the Federation and other at scale groupings will be sent to all practice managers.

The Federation will “piggyback” on schemes of other at scale providers where they benefit our services e.g. Walton Surgery in Felixstowe working with Suffolk Primary Care on £3 per patient initiatives.

Current Federation governance arrangements

The Federation has a Conflict of Interest policy and Register of Interests. These are overtly checked at the start of every meeting. Individuals declare when they have a potential conflict of interest and we put structures in place to ensure this does not influence outcomes.

The Federation’s legal construct is a Limited Liability Company and by law directors are required to act in the “best interests of the company”, rather than personal or practice shareholder interests. This is clear in the new board members’ induction pack.

The Federation works as a membership organisation and all opportunities are offered to all member practices equally. The Federation now provides primary care services at Walton and Haverhill, and we carefully consider ensuring we do not disadvantage other member practices in their operations.


The Federation’s approach has always been to be open and transparent. We are currently considering how best to keep members informed. I feel the newsletter has gone some way in getting information out to practices.

We are looking at how best we can share the decision-making processes with members e.g. board meetings without compromising commercially sensitive data or putting information in the public domain about new services.

The Integrated Governance Committee (more in my next blog) is asked to approve projects where the Federation either shares with other at scale initiatives or piggybacks on any new innovations.