RT Journal Article
SR Electronic
T1 The impact of new forms of large-scale general practice provider collaborations on England’s NHS: a systematic review
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e168
OP e177
DO 10.3399/bjgp18X694997
VO 68
IS 668
A1 Luisa M Pettigrew
A1 Stephanie Kumpunen
A1 Nicholas Mays
A1 Rebecca Rosen
A1 Rachel Posaner
YR 2018
UL http://bjgp.org/content/68/668/e168.abstract
AB Background Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant.Aim To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England.Design and setting Systematic review.Method Embase, MEDLINE, Health Management Information Consortium, and Social Sciences Citation Index were searched for studies reporting the impact on clinical processes and outcomes, patient experience, workforce satisfaction, or costs of new forms of provider collaborations between general practices in England.Results A total of 1782 publications were screened. Five studies met the inclusion criteria and four examined the same general practice networks, limiting generalisability. Substantial financial investment was required to establish the networks and the associated interventions that were targeted at four clinical areas. Quality improvements were achieved through standardised processes, incentives at network level, information technology-enabled performance dashboards, and local network management. The fifth study of a large-scale multisite general practice organisation showed that it may be better placed to implement safety and quality processes than conventional practices. However, unintended consequences may arise, such as perceptions of disenfranchisement among staff and reductions in continuity of care.Conclusion Good-quality evidence of the impacts of scaling up general practice provider organisations in England is scarce. As more general practice collaborations emerge, evaluation of their impacts will be important to understand which work, in which settings, how, and why.