GP partnership model could be abandoned in parts of England, says Fuller review author

Dr Claire Fuller, a GP and senior responsible officer of the Surrey Heartlands Integrated Care System, told a Policy Exchange conference that in some areas it was difficult to recruit partners.

‘I think we should look at a different model in those places,’ she said, adding: ‘In the areas where it isn’t working, I would then look differently within the members of the labour team or members in the place team to look at a different model or kind of local solution.’

The general practice partnership model has become a focus of contention between ministers and the BMA recently. A report by Policy Exchange backed by former health secretary, Sajid Javid, called for a shift to providing primary care under large-scale providers from as soon as 2024 – and claimed the partnership model was in ‘terminal decline’.

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But at a recent UK LMC conference GP leaders said a nationalised general practice service was not in the best interests of patients and urged the BMA to take ‘all necessary action’ to defend partnerships.

Dr Fuller said problems with the GP partnership model were outside the scope of her Fuller Stocktake report – but acknowledged the picture was mixed across England.

She said that in parts of the country including where she works in Surrey, ‘the partnership model is working and is thriving’. ‘I always come back to – if it’s working – why on earth would you look to disrupt? But in the areas where it isn’t working, we need to look differently.’

She suggested that integrated care systems could create more freedom within the NHS to deliver local solutions.

Local solutions

Dr Fuller said: ‘One of the points of having an integrated care system is that ability to flex the funding locally to areas of greater deprivation.

She said examples cited in her stocktake report showed that different local approaches were possible – but stressed they should be ‘locally focused rather than doing something sort of top down centrally’.

Numbers of GP partners have declined sharply over the past decade, with more than 2,000 full-time equivalent partners lost in the past three years alone.

The decline in partners has not been even across the country, with some areas losing GPs in partnership roles at a far quicker rate than others. NHS England’s ‘new to partnership’ scheme, which offers golden hello payments to clinicians taking on partnership roles for the first time appeared to have slowed the fall in GP partner numbers – but doctors have said comments from Mr Javid have deepened wariness in the profession over taking on the role.

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