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Ben talks to Rebecca Rosen, a GP and author of a new report from the Nuffield Trust called “Is Bigger Better? Lessons for large-scale general practice”. They discuss the benefits of working at scale including the impact on staff and patients and the surprisingly limited impact on quality. Rebecca also has advice for practices thinking of working at greater scale and for CCGs who are supporting the development of General Practice.

Show Notes

Rebecca explains how the report grew out of research undertaken by the Nuffield Trust (1min 23secs)

One of the headlines is that larger scale has little impact on quality (2mins 08secs)

The four quality measures used in the report (3mins 03secs)

The research organisations weren’t necessarily established as quality improving organisations (4mins 35secs)

What benefits did they find of operating at scale? (5mins 39secs)

Positive impact on staff – apart from salaried doctors (8mins 06secs)

Operating at scale as a response to the crisis in General Practice (9mins 21secs)

Continuity of care for patients (10mins 48secs)

Advice for at-scale General Practice organisations (12mins 16secs)

Where should at-scale organisations start? (13mins 13secs)

Working at scale versus complete merger (14mins 43secs)

The role of CCGs in supporting at-scale General Practice (16mins 44secs)

Is bigger actually better? (18mins 50secs)

Finding the report (20mins 14secs)

The report is available here http://www.nuffieldtrust.org.uk/publications/bigger-better-lessons-large-scale-general-practice