General practice networks are becoming increasingly common across the UK as practices look to share costs and resources, including workforce and facilities, or enhance the ability to bid for enhanced service contracts. But what should practice managers keep in mind when actively establishing, or joining, a GP network?

The big question which impacts on most subsequent decisions and the complexity of future plans is what do you want the network to do? The British Medical Association says: “If the network’s ambition is to only deliver core services or provide a mechanism for staff development (e.g. training) functions, there may be no need to create a new formal structure (e.g. a legal entity). In this instance, there are more informal ways of developing collaborative support between practices. If the network’s aspiration is to share staff, bid for contracts and deliver a wider range of services, then it should strongly consider forming a new legal entity.

Agreed approach

Whatever the ultimate goals, a network should ensure everybody in the pact is working towards common targets. For example, if the network is to bid for contracts and deliver services beyond the core GP contract, it should develop an agreed approach about which new services it is looking to provide, how and where it will obtain new contracts, and how it will deliver them.

In working out future goals, questions to ask include:

• How ambitious are the members of the GP network?
• What are the strengths and weaknesses of the constituent practices?
• What facilities and resources will be available to the GP network?
• What is the demographic and/or health profile of the local patient population?
• What health services are commissioners likely to be procuring in the future?
• How will resources be distributed?

Economies of scale

Another of the major questions practices often ask is to do with GP network size – is there an optimal level?

The BMA says there are few hard and fast rules about the ideal list size for the whole network, but in general there is more strength as a provider if the GP network covers a large population. It goes on to add that any GP network with a patient population smaller than about 50,000 is unlikely to have a significant influence with commissioners, although this is not to say that such a GP network wouldn’t be an effective vehicle in the provision of mutual support and coordination for its constituent practices.

Similar to patient size, there is no ideal figure when it comes to the number of practices making up a GP network, although economies of scale do come into it and make a larger group more appealing. For example, a GP network of 20 practices may not have significantly greater running costs than a GP network of five practices. On the other hand, the ability to engage and communicate with each constituent practice will become more difficult as the number of practices grows. It’s a careful balancing act.

If you can’t beat them…

Past experience suggests that most practice managers would agree that if there is already a network organisation operating within the area of your practice, it may be preferable to explore the possibility of joining this in the first instance, rather than setting up a competing organisation. There is no doubt that smaller networks are more likely to waste time and energy competing with one another.

GP networks can bring plenty of cost-saving and service-winning benefits to practices, particularly if the end goals are clear to all involved. Once the goals are in place the fun can begin, setting up a network of your own!

Has your practice recently joined a network? Have you been a part of the creation of a new one? What tips from the planning process can you share with your fellow practices? Please comment below or discuss in the Practice Index Forum.