Royal College of General Practitioners 2020 strategy endorses GP federations

The RCGP 2022 GPs – A Vision for General Practice contains a section on GP federations which we have reproduced below.

Working in federated organisations (organised networks of teams)

The general practice teams of the future will be working with groups of other practices and providers – as federated or networked organisations. Such organisations permit smaller teams and practices to retain their identity (through the association of localism, personal care, accessibility and familiarity) but combine ‘back-office’ functions, share organisational learning and co-develop clinical services.

Federated or networked practices are therefore well positioned to act as the provider arm of local communities and can work together to provide extended services (such as those currently defined as ‘enhanced services’), as well as providing community nursing services and GPs with extended clinical roles.

Within federations, patients are more than likely to be able to self-refer, if they wish (or be cross referred within the federation), for physiotherapy, talking therapies and other services provided in community-based clinics. Patients who require routine care will be more than likely to receive this from a range of community-based providers working as a team – including primary care nurses, healthcare assistants, pharmacists, physiotherapists, mental health workers and GPs.

Practices within federations will offer more community services to the population registered within their respective practices – for example, dietetic services, podiatry, and outreach services dependent on GP skills (e.g. minor surgery and complex contraceptive services).

Some practices will form large federations, incorporating hospital, third-sector, private and community providers.

The GP of the future is likely to be contracted using a number of arrangements, including, but not exclusively, as a salaried practitioner (either as part of a larger provider organisation, a federation, foundation or equivalent trust, or an employee of a third-sector and/or private company organisation) and/or as a self-employed practitioner.

Federated organisations will be better able to coordinate out-of-hours care and ensure the provision of personalised care for those patients who particularly require continuity with their treating team, both in and out of hours. They will also be better placed to monitor, understand and manage inappropriate variability in clinical performance, through joint learning approaches, audit, peer review and other quality-improvement mechanisms.

Source: 2022 GP – A Vision for General Practice – June 2013