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Scaled up general practice organisations do not provide better quality of care, report says

BMJ 2016; 354 doi: (Published 19 July 2016) Cite this as: BMJ 2016;354:i4002
  1. Matt Limb
  1. London

General practices that pool their resources in bigger partnerships or by working together in federations may see some gains in operational efficiency and prescribing but there were few signs that this “scaling up” had improved the quality of patient care, a study by the Nuffield Trust has said.

The 15 month study showed that three quarters of practices were now involved in bigger partnerships or federations, but that this had not boosted performance against a range of quality indicators and that patient satisfaction had fallen.1

The report’s authors called for a “phased introduction” of alternative contract models for large scale general practice organisations and integration with community providers, citing “insufficient evidence that large scale general practice will deliver high quality, cost effective care that is valued by patients.”2

Rebecca Rosen, senior Nuffield Trust fellow, said that, while large scale …

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