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08th November 2015

Is Bigger Really Better?

Small practices more likely to be inadequate

Last month it was reported that smaller practices may be struggling to compete with larger practices when it comes to achievement. A GP online investigation compared CQC ratings data from over 1,700 practices to the most up-to-date practice list size data, revealing that ‘outstanding’ practices have, on average, a list size twice as large as the average ‘inadequate’ practice.

Single handed GP Practices have been highlighted for years as being vulnerable to takeovers and even closure but they are now receiving criticism from the CQC for working in professional isolation and less likely to be open and transparent, resulting in a lack of communication and engagement with staff and patients.

Working together

It is clear that the CQC, CCGs and LMCs would encourage practices to work together, and collaboration and federation is always at the forefront of conferences, meetings and discussions, particularly since emerging GP federations are aiming to deliver against the NHS Five Year Forward View. Although traditional GP practices will remain, the Forward View considers that primary care will eventually be delivered by groups of practices. Many GP practices already work closely together but the feeling is this will start to become a more formal arrangement which will protect smaller practices.

Bigger isn’t always popular

Many smaller practices have a close relationship with their patients and score highly on patient satisfaction surveys. They are often more aware of their patients’ family and social history and give a more personal service than many larger practices, and patients love this to the extent they are often willing to overlook or forgive weaknesses within the services that their practice provides. What smaller practices often lack is sufficient funding and with additional support, rather than size, these practices could evidence they can compete with the big boys.

Whilst there will be some under-performing doctors and practices only a few will be unwilling to improve and evidence that their services are, at the very least good. It is important to understand how and why they are struggling and maybe, even in this day and age of resources and technology, they just don’t know where to start or where to find help. However practices using the QCS Management System will know very well that the support is available and accessible to help them exceed the standards.

Alison Lowerson – QCS Expert GP Practice Manager Contributor

Topics: GPs

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