Doctor with male patient

Do GP federations have a role in the NHS? And what is the impact on general practice?

In our work, we find some practices are still doubtful about the need for a GP federation. However, with the emergence of the Primary Care Networks (PCNs), we believe that you could be missing an opportunity if you are not considering creating, reviewing or refreshing your federation.

A GP federation offers scale to general practice and provides the opportunity for it to have a single voice of strength across a whole health economy. This in turn provides the opportunity for the voice of Primary Care to be heard as Integrated Care Systems develop and evolve.

PCNs, with populations of 30,000 to 50,000, working within an overarching GP Federation, therefore, appear to offer an excellent model of working and it is one we have supported and developed many times.  

In the illustrated example, the PCN Clinical Directors meet monthly with the Board of the GP federation and include the Local Medical Committee (LMC) in the meeting membership.

This model ensures one very strong and coherent voice for general practice in any other system meetings in which it is represented. Those attending the system meetings on behalf of general practice are responsible for ensuring the communication bridge between the federation, PCN and practice. They carry the view from this monthly board meeting into any system meetings they attend.

Any requests or actions for practices, PCNs or the federation come back to that group for negotiation, agreement and ultimately implementation.

We are finding this, or similar approaches are quickly gaining prominence in preference to a legal entity Primary Care Network, or a lead practice model. The lead practice model, in our experience, being by far the least popular.

What is also clear is that where a GP federation has been established but hasn’t yet matured into a delivery model with active engagement from member practices, this needs to be rapidly addressed if the federation is to successfully take on the role outlined above.

The employment of staff via the federation will naturally be an important consideration, particularly with the new roles coming into general practice, as the company manages the employment risks for the practices. You may want to start those conversations with your federation.

The legal entity federation model will easily facilitate the employment of these roles, particularly if the federation holds NHS Employing Authority Status and can include these roles in the services that attract that status. 

If you would like more information on the role of a business-ready GP federation and how it can positively impact a local health economy and support the PCNs with remarkable delivery, we would be happy to discuss.

If you can already see the benefit from active support to become a business-ready PCN or federation, with fully engaged practices capable of remarkable delivery, we would be delighted to show you how you can quickly achieve this.

The Primary Care Team in SCW continues to provide support and direction to practices, Primary Care Networks and federations in working to successfully implement new care models, develop connections and work collaboratively within Integrated Care Systems.

Our aim is to enable health and care systems to achieve the best possible outcomes for people, communities and populations 

For more information on our support packages, or if you have any questions, please email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Director of Primary Care, Strategy and Transformation

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