1. Transforming General Practice
Unlocking the Potential

3. Current Market Context
• Increased demand for primary care
• GP contract – doing more for less
• CQC and new QoF - ‘demonstrating quality’
• CCG developments and pressures on
commissioners
• Shift of focus of care from secondary to primary
• Greater cooperation with social care
• GP demographics

4. Traditional Practice Model Federations ‘Super Partnerships’
(Sole trader, multi-partners)
Full
Merger/Integration
CollaborationConsultation
2k – 15k patients 30k – 500k patients 80k + patients
Emerging Models in General Practice

5. The Vitality Partnership
• Built on local general practice with local GPs
• Single partnership
• Delivery at scale: 50k + patients
• Clinically and quality focused
• Commercial structure

6. The Numbers…
List size:
•2009 26k
•2010 32k
•2011 38k
•2013 50k
(LCG 125k, CCG, 550k)
• 15 equity partners
+ 3 fixed share partners
• PMS and GMS contracts
• £10m+ turnover
• 200+ staff
• NHS specialist services
• Private services
• 7 primary care sites (plus
university sites)

7. Partners
Salaried
Partners
Associate GP
Salaried GP
Corporate Overview

8. Partnership Structure
• Executive Partner
• Medical Director
• PPI lead
• HR and workforce
• Estates
• Commissioning
• Director of Primary
Care
• Director of Specialist
Services
• Outlet Directors
• Comms and
marketing
• IT and informatics
• Teaching/Training

9. Organisational advantages
• Deliver Services at scale
• Long term planning and investments
• Greater ability to bid for AQP
• In house business development
• Greater level of local influence
• Staff employment protection and development
• Multi -sites – patient choice
• Standardised policies and procedures

10. Clinical Quality
• Increase in overall quality in merging practices
(QOF points increase, access increase, range of
services)
• Increased uptake of flu vacs, cytology etc.
• Reduction in OPD referrals in merged practices
• Integrated care pathways
• Single patient record (EMIS web)
• Peer review of referrals and prescribing

11. Patient Engagement
• Greater level of strategic discussions
• Increased scope of topic feedback
• Changes to practice information – pt led.
• Prompt feedback on service change
• Innovative surveys

12. Challenges
• Clinical time investment into merged practices
• Financial investment
• Culture change – partners and staff
• Communications – vision and decisions
• Local GP politics
• NHS in transition (PCTs/NCB/CCGs)
• Accurate data to enable service planning and
evaluation
• Optimum size? How much risk?

13. Challenges (2)
• Lead and manage merger and acquisitions
• Strategic business and investment planning
• Organisational development
• Property and estates support
• Legal, accountancy, financial management and
HR support
• New business and market opportunities

14. Our Vertical Integration
•Rheumatology
•Dermatology
•Orthopaedics
•Immunology
•Substance Misuse
•X-ray
•Intermediate Care
•ENT
•Urology
•Paediatrics
•Neurology
•Pain Management
•Gynaecology

15. Our Horizontal Integration
• Community partnerships
• Health and wellbeing services
• Social Care
• Mental health

16. Vitality Partnership
Innovative
Organisational
Dynamic