Collaborative ‘at-scale’ models are increasingly being heralded as the answer to the formidable challenges facing general practice. NHS England has signalled that large-scale general practice organisations should form a core component of their vision for new care models set out in the Five Year Forward View. But can these organisations really deliver what is expected of them? This report presents findings of an extensive literature review examining the evidence.
In this paper authors present the findings of a review of the literature which contributes to the Nuffield Trust’s stream of work on large-scale general practice, including the recently published findings of a 15-month mixed methods research study, Is Bigger Better? Lessons for Large-Scale General Practice.
The report, published in collaboration with the London School of Hygiene & Tropical Medicine, aims to answer the following questions:
1. Which organisational form(s) have large-scale collaborations of GP practices adopted in England?
2. What are they expected to deliver?
3. What evidence is available on their impact in England?
4. What can we learn from initiatives with similarities?