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Primary Care Support

Federations, Practice Mergers, Income Generation & Access

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Gain Share


How your Federation can benefit?

How to negotiate with your CCG

Recent work with a GP Federation in the midlands successfully secured them a gain share agreement from the local CCG. This is now being used as a catalyst to further engage the Member Practices while building the collaborative relationship with the CCG and other local providers.  


To further explain, a gain share agreement, creates a win:win situation. It is a way of sharing risk between a CCG and a provider, where any planned savings are shared at an agreed percentage between each organisation.


Where a GP federation can agree gain share, it should then be confident that this approach encourages collaboration between the CCG as a commissioner and the federation as a provider, to identify savings and then work collaboratively to achieve them.


This scenario opens a significant new opportunity for GP federations, where many remain trying to get the first piece of business that then secures their ongoing development.


To ensure that you can maximise this opportunity Scott McKenzie UK has developed a one day workshop to help you understand and then use the gain share approach within your work.

Within this workshop, you will learn:


•What a gain share is

•How gain share works

•The opportunity for a GP federation

•The projects my client base a has then invested their share of the money in

•How you create your value-added projects and align them with the CCG and STP plan to secure the go ahead

Slice of the cake

We will also provide an understanding of at scale provision in the NHS. This includes Sustainability and Transformation Plans, how and why GP federations must interact with the STP and the New Models of Care, through Multispecialty Community Providers (MCP), which also includes the Primary Care Home ( and Primary and Acute Care Systems (PACS).


The workshop ensures you understand the process and the outcomes you can achieve.  This will provide a firm platform to build from, in developing and implementing remarkable projects.


No two gain share agreements are the same, nor are the services into which the savings have been reinvested. What they do have in common, though, is the ability to first transfer the care from in hospital to out of hospital care and then, through the federations, transform the delivery – normally onto a hub and spoke basis to avoid unnecessary duplication in service provision.


The key is that there are numerous basic services that can easily be shifted from in hospital to out of hospital delivery. By generating efficiency through a gain share and then investing it in to this type of service, you can start to drive a change in the way Practices engage and work at scale through the federation. These services also bring new income in to the practices.


In most parts of the country the local GP federation badly needs a catalyst; a gain share agreement is one way to provide that catalyst. The reinvestment in services further underpins that by building a platform for changing the way practices work together, through hub and spoke, underpinned by inter practice referral.


The goal of achieving one, high quality and standardised approach without unwarranted variation, is deliverable through these projects, which provides a platform for the larger and more complex system-wide changes required.


Gain Share picture 1.

The drive behind this workshop is to support you to understand then develop and implement a gain share agreement between CCGs and federation. My confidence that this approach can and will secure the outcomes you seek is predicated on the highly successful track record I have in establishing new federations before supporting them to go on and secure the contracts that secure long term viability of the new company. Additionally, the gain share approach fits with the Sustainability Transformation Plan approach to move work from in to out of hospital care.

This project builds on that track record and draws upon a number best practice options we utilise including gain share, which is the most likely route to rapid implementation and outcomes.


The combination of a process-led approach, complimented with strong implementation, secures excellent outcomes and income for our client base, where we have many examples to call upon.