Practice resilience

General practice is under unique pressure due to sustained under-funding and increasing patient demand and complexity.

GP Forward View, the College endorsed NHS England initiative, pledges significant new ongoing investment in primary care, as well as a number of programmes designed to sustain general practice in the short to mid-term. The practice support service is an essential first step in sustaining practices.

The provision of support to vulnerable practices is embedded in the College’s core values and strategic objectives:

  • Setting the highest standards for general practice
  • Supporting GPs throughout their professional lives to deliver the best possible service
  • Leading the profession and demonstrating the value of general practice

RCGP Peer Support Programme for practices placed in special measures

The NHS England-funded programme for practices closed to new applicants in October 2017 and now any practices placed in special measures may be eligible for funding through NHS England or their CCG from the GP Forward View Practice Resilience Fund, or practices can self-fund support.

RCGP Practice Support Services

The College already has an excellent track record in supporting practices in difficulty through the national Peer Support Programme for practices placed in special measures. Since 2014 our team of 80 clinicians and experts have worked with over 200 practices, driving improvement and successfully supporting practices.

How can RCGP help you?

The RCGP can offer diagnostic assessment and targeted support tailored to meet the particular needs of practices.

Diagnostic review

We have a national team of GPs, practice managers, practice nurses and pharmacists who can be deployed to support the practice with in-depth expertise and root cause analysis. Our advisors will work with the practice team to diagnose where the issues may lie and develop an action plan with them.

Our service:

  • works with GPs to understand the issues within the practice
  • provides a diagnostic report and supports the practice to develop an action plan
  • works with the practice team to prioritise the actions
  • provides signposting to specific support and training suppliers.

Targeted support

The College can offer specific, time-bound interventions, which can be aligned with CQC themes - safe, effective, caring, responsive and well led - and will also provide a holistic review, looking at performance overall and identifying blockers to progress. Working with existing practice resources is a key component of the support and is vital in order that changes become embedded and sustainable.

Each targeted support intervention can be tailored to the needs of each practice but can include:

Workforce / capacity issues

  • WF analysis/scoping
  • Optimising skills mix
  • Demand management
  • Recruitment/succession planning
  • Supporting working at scale – particularly mergers


  • Financial health checks-reviewing income generation and expenditure
  • Contingency planning
  • Developing a business case


  • Negotiating leases or notional rent
  • Optimising use of premises

Organisation and leadership

  • Developing leadership skills
  • Training and development including active signposting, clinical correspondence, practice manager masterclasses and moving into management modules
  • Optimising work streams including reviewing back office functions/GP admin
  • Supporting change management/QI
  • HR management


  • Mentoring individuals and teams
  • Improving collaborative working and developing peer support
  • Conflict resolution
  • Providing advocacy with external organisations
  • Running practice away days

Providing a high-quality service is fundamental to the College. Each piece of work will be subject to review by the RCGP Medical Director for Practice Support Services. A clinical lead is always available to support advisors on urgent matters.

Feedback received from practices benefiting from the RCGP support:

"I believe we have the best Practice Manager in the RCGP support team. Thanks very much for your unbounded energy and support to our small team, you brought hope and clarity in troubled times, you give your all and more, more than we could ever fairly ask for, you have been on the journey with us, at all time, in all hours of day and always with a smile and offering more support. The value of your service could not be repaid in £. We (Staff and patients) owe you tons more! Thanks to RCGP for creating the framework and thanks to all in the team for working super hard!"

"First of all me and my team would like to thank you for a comprehensive feedback report, which will help us to improve quality of care for our patients and continue to maintain the high standards of care. RCGP helped to formulate a structure of leadership in the practice. We were enabled to build a reflective practice which is effective and safe by use of tools like audits, regular reviews of our significant events, complaints and patient survey analysis. They helped us in team building through away day and staff surveys. Both the GP and practice manager visited the practice many times and were always available to seek advice. In fact we find, the skills we learned from RCGP team did not only help us achieve the desired ratings but will also help us to provide best care to our patients on a regular basis."

"I was very pleased to see that the practice had a strategy to maintain the delivery of quality care in order to improve outcomes for patients. There was a documented leadership structure and staff felt supported by management. “Patients spoke positively about staff at the practice and said they were treated with dignity and compassion. The practice was rated above average for nurse consultations in comparison to both local and national averages. The majority of patients stated that the last nurse they saw was good at listening, treating them with care and involving them in decisions. All of the staff should be extremely proud of what they have achieved and I applaud the dedication and commitment they have shown to improving the care of their patients."

Further information

This is a bespoke service which can be designed around the needs of the individual practice or a group of practices. For further information and to discuss your needs please contact our team at

A case study [PDF]

GP Excellence - The RCGP Strategic Partnership with Greater Manchester HSCP

Practice Healthcheck Diagnostic Tool (October 2017)

Regional Events 2017

Summary of the Special Measures pilot findings

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