General Practice at Scale

The challenges facing general practice are well documented and we recognise that working at scale is one way to meet these challenges. Funded by NHS England, this project strives to obtain a better understanding of the formation of networks of GP practices and primary care networks as well as provide support to practices and collaborations who are scaling up through our GP At Scale Online Learning Network and newsletter.


GP at Scale
 (previously supporting federationsrecognises that there are several models for how practices are working together. Two or more organisations work collaboratively (either formally or informally) in their front or back office functions or work to group together to win provider contracts. Groupings include federations, networks, multispecialty community providers (MCPs), primary and acute care settings (PACs), joint ventures, super practices, multi-site practices. The key aspects are that general practice is essential to the grouping.

    GPAS Survey

    The RCGP is working to better understand the landscape and inform the debate around of new models of primary care and to support practitioners to navigate the challenges in this changing environment. 

    Following ou2015 and 2017 surveys, we've launched our 2019 survey to understand GP at scale and its integration into primary care:

    • What have been the changes and challenges?
    • How are people progressing and operating in collaborations and networks?
    • How much integration is there in the system and
    • How much of it is led by primary care?

    We would be grateful for your support in completing the 5-10 minute survey by 18 February 2019. We're especially interested in the views of general practices, at scale organisations and primary care networks or partnership between GP practices, community services, and social care. 

    We look forward to sharing initial findings at the GP At Scale National Summit on 7 March 2019.

    Your responses will be completely confidential, anonymised and stored securely. If you have any questions, please contact the RCGP GP at Scale Team via email:  gpatscale@rcgp.org.uk.

    National Event

    The RCGP will be holding the GP at Scale National Summit on 7 March 2019 to explore the Future of General Practice, what the Long-Term Plan, Partnership Review, Estates Review, Primary Care Networks, and IT Futures means for GPs and general practice. 

    The day will be filled with lots of interactive topics including team-based care, moving from practice-based care to network-based care as well as leadership and influencing the system.

    Click here to find out more and register your place!

    Quality and Efficiency at Scale

    Prior to the development of Primary Care Networks, using the RCGP Position Statement on Quality in General Practice as a framework, the College interviewed six ‘at scale’ organisations to learn more about quality and efficiency at scale.

    We have evaluated these organisations and produced a 'General Practice at Scale: A cross organisational examination of quality and efficiencyreport, which outlines how these six organisations were improving the quality of care they provide and the efficiency of their practice operations.

    The key results from the interviews include: 

    • Practices are merging for more than just financial efficiencies, economies of scale and recruitment challenges.
    • Practices merge to deliver better care to their patients and to deliver care in the communities.
    • There is a difficult balance to develop between access to care and continuity of care, different models of care are developing across the country to address this.
    • Through coming together, at scale organisations have more opportunities to innovate and to support patients in different ways, such as through multi-disciplinary team meetings, group appointments, increasing appointment times, the use of allied health professionals in practice and for home visits, increased access, and improved estates.

    Online Learning Network

    The RCGP General Practice at Scale Online Learning Network provides information and support around general practice working at scale. We have developed an Online Learning Network to facilitate the sharing and signposting of useful resources, case studies and enable users to network with colleagues across the country.

    Through this network and in combination with regional events we are connecting with, and learning from, at scale organisations about how and why they are forming and what makes them successful, bringing together GPs and helping to navigate potential problems and pitfalls.

    We hope that you will find on here useful resources and case studies as well as opportunities to share learning from your experiences and make useful links with other at scale organisations. Whether you have been working at scale for a while or just want to find out more, this network can support you in your journey and connect you to colleagues across the country who are working in innovative ways.

    Whether you have been working at scale for a while or just want to find out more, this network can support you in your journey.

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