The world has changed so much in recent times that we now face some fundamental philosophical questions, including, “What constitutes a GP practice?”

According to Wikipedia, General Practice is “services provided by general practitioners”. Let’s not dwell on how out of date that is, or how disrespectful it is to all the other clinicians apart from GPs working in general practice, and instead note that it is probably not adequate as a definition.

The NHS Data Dictionary defines a GP Practice as an “organisation”, practising on their own or in partnership, which “may operate from multiple sites”. Here, as is all too common, the practice has been defined (at least in part) by the premises from which it operates.

But the shift to remote working, accelerated by Covid, as well as the introduction of PCNs mean that defining a practice by the buildings in which it resides is no longer helpful. It is no longer true that anyone working for a GP practice is only “working” when they are in the building. They may be working at home (or any remote location), or providing services out of another practice or physical location as part of a PCN-wide service.

Indeed one of the huge challenges facing practices at present is being able to operate effectively out of the limited space they do have available. This is the challenge that our panel consider in this month’s Practice Index podcast. They come up with some interesting ideas and advice for practices, including:

• Don’t discard remote working simply because you don’t have to use it. Regularly scheduling remote sessions for clinical staff keeps the practice and remote working skill set up to date, and enables a more productive use of the limited available practice clinical space. However, you do need to ensure that, where staff (in particular ARRS staff) have significant amounts of time working remotely, they still feel like part of the practice team.
• Consider basing the back office administrative function off site. Clinical space is at a premium, and if more can be created by moving non-patient-facing activities to another location, then this is an option worthy of serious consideration.
• Convert non-clinical space into remote clinical space. Our panel advocate creating remote working booths within practices to allow the overall capacity to be significantly increased. This opportunity may be greater than practices currently think once the move to digitised medical records finally takes place.

The panel also suggest other really interesting options, such as creating hybrid meeting rooms that allow in-person and remote attendees. Do listen to the episode to hear more of the detail of what they had to say.

But back to the philosophical question – how do we define what a GP practice is? If the building is no longer a useful part of the definition of a GP practice, then what should it be based on? It is the patient list that defines a GP practice. GP practices are organisations that work to meet the needs of their registered patients and, these days, use multiple professionals, sites and partners to achieve that end. It is the role of the practice manager to continually innovate to enable this work to be delivered, whatever space or staffing constraints the practice may face.

Click play to listen to the podcast here: