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Primary Care Support

Federations, Practice Mergers, Income Generation & Access

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At SMC we support the development of GP Federations/GP provider Companies to deliver high quality patient outcomes with financially viable solutions, in order to close the gap in reduced income through current arrangements, e.g. LES being reduced, and the future need to bid for Any Qualified Provider (AQP) contracts and NHS tenders.


This work supports practices to tackle the very real and present threat to General Practice in the form of AQP where they will need to be ready to respond. Federation is therefore possibly the biggest opportunity for General Practice there is at the moment, without this General Practice is quickly going to find itself working on core contract and nothing else. Most practices would struggle to compete with AQP individually and in essence the commissioners don't want lots of little contracts with variation in delivery going forwards, meaning the federation is a key vehicle for the future.


Additionally, you need to keep in mind that all LES must move to a standard "part b NHS service contract", and in the process CCGs are expected to market test these, meaning Practices will face the prospect of an AQP tender to retain the work. There is no longer a mechanism for the CCG simply to pass these to General Practice, without risking a challenge from other provider and companies (including the FTs) who would like to deliver them, putting income immediately at risk. We have come across areas of the country now where notice has already been served to the practices on all LES, and confirmation given that AQP will be used. In the North East I recently met with an Accountable Officer who confirmed the legal advice they have been given is that there is "no other way" and they will now move to serve notice.

Our support lies in either the development of the companies and then supporting them move forwards, or for those who are already set up they simply want my input and commercial focus to get them going. In the delivery we draw upon our management capability to ensure a smooth implementation, by matching our skills to the needs of the provider company.  Additionally we are highly flexible and quick to respond to your needs, and can work to incredibly tight timescales to meet your deadlines. In Newcastle we developed their principles in two meetings on 3rd and 10th September and held the launch meeting a week later on the 18th.  


Within the team we have expertise in initial company formation, developing business cases, negotiating contracts, writing bids and tenders, reducing expenses for member practices, increasing income or providing regular hands on management.

We have a highly successful track record and draw upon best practice utilising a number of unique approaches (capital on the basis of a loan is one of those). The combination of a process-led approach, combined with strong implementation, secures excellent outcomes and income for our client base.

Frederick Wilcox quote (long) Contracting Models
Federation Board Development Workshops