The BMA has produced a new document, ‘Safe Working in General Practice’. Now you might assume, particularly if you have read the accompanying headlines, this is simply a call for a limit to general practice workload and to establish 15-minute appointment times. But you would be wrong.

The document is actually about the introduction of what it terms ‘locality hubs’. These provide additional primary care capacity in a locality, delivered through multidisciplinary teams, and are created as a result of collaboration between practices. They operate as a place where triage can be managed centrally, and on-the-day demand can be managed across multiple practices in one location using a much wider skill mix.

The concept is not new. It was introduced in the General Practice Forward View (GPFV), where they were described as primary care access centres. The BMA say,

‘The sole initial purpose of locality hubs is the stabilisation and sustainability of general practice. Hubs are not walk-in centres: each hub would help manage demand across a number of practices and their respective patient lists, ensuring that patients in excess of safe working limits can still be seen by a GP or the wider primary care health team.’ p5

While the presentation by the BMA is in terms of a protection of core general practice, the reality is the model they are supporting is highly progressive. It incorporates all the key features of ‘modern’ general practice: the introduction of new roles; general practice operating at scale; the integration of practices with the wider health and social care community; and the development of the new models of care.

There is an unusual alignment in that the profession itself needs exactly what the wider NHS needs, manifested in these locality hubs. At the same time as providing support for core general practice, the system receives better access, more responsiveness, and an ability to deliver more joined up care, particularly between community services and general practice.

The sticking point is normally the funding. But as the BMA rightly point out, the funding has already been identified. The GPFV promises a further £500m per year recurrently from 2020/21 for extended GP access, and £171m between now and then from CCGs to support the development of this capacity. There is no obvious other route for this capacity to be delivered. There are no more GPs. Existing practices cannot take on any more work. This has to be the answer.

In what could be viewed as a once in a lifetime event, the stars are perfectly aligned. The profession wants the hubs, NHS England wants them, they fit perfectly with the introduction of the new models of care, and the funding is already in place. Opportunities like this are exceedingly rare, and must be grasped with both hands. While making the locality hubs a reality will still require conversations, trust, joint working, leadership and hard work, now is the time to do it. Seize the moment, because it may be a long time before another one like this comes along.