Largescale Primary Care

“If general practice fails the whole NHS fails” Simon Stevens, CEO NHS England


It has been recognised within the Five Year Forward View that General Practice has been under significant strain over the last few years and that additional funding and different models of care have been required to support the rising patient demand, the escalating healthcare needs and the lack of GPs and other healthcare professionals within the system.


The challenges facing general practice in Somerset, as well as nationally, remain significant and in Somerset specifically there is a high proportion of small and rural practices, with 38 of the 65 practices (58%) in Somerset retaining a list size smaller than the national average (8,985).


In South Somerset, the proportion of residents aged over 65 is also higher (23.3%) compared to the rest of England (19.6%). This is forecasted to grow and the increased demands on health and social care and the increased working age population means that the pressures felt by general practice continue to accumulate.


One option intended to support the known difficulties within primary care is to increase the scale at which it works. By coming together within a ‘largescale primary care organisation’ it allows for certain efficiencies by preventing duplication of effort within areas such as HR, finance, data analysis and workflow administration.


Despite this, General Practice has arguably been under so much pressure that even this is not enough and further work has and continues to be required to support a sustainable position.


Following the merging of Oaklands Surgery and Yeovil health Centre during September 2017, four further SHS practices merged into two during 2018/19 to support the stability of these sites; prior to this more than half of the SHS practices patient populations were below the national average. This continues to endorse the premise that practices should be of a certain size to remain sustainable and further supports the introduction of Primary Care Networks  during 2019/20; demonstrating that you can work at scale without integrating too.


We are confident in SHS that largescale general practice is the future, not only to create a sustainable healthcare service but to provide a working environment that is attractive to all healthcare professionals.