- A fraction of the primary care networks in England are made up entirely of super-partnerships
- Most of the existing at-scale GP providers make up the minority of the PCNs their members have joined
- Half of the largest 60 GP practices in England have formed single-handed PCNs
There are seven primary care networks entirely made up of multi-practice GP providers, with a further 38 composed of a single very large practice, according to data collected by HSJ.
Large-scale providers like Modality Partnership or Our Health Partnership, which operate across multiple practices covering tens or hundreds of patients, feature in 141 PCNs.
However, a very small fraction of the approximately 1,250 networks in England are entirely made up by the practices of a single large-scale provider.
In 20 more PCNs, the majority of member practices are part of a single large-scale GP provider — often a “super-partnership” — and another 21 PCNs have more than half their total patient list registered with a single large multi-practice provider.
Meanwhile, 38 PCNs have only one member, which is a large practice, normally operating across multiple sites, but with a single primary care contract.
The majority of these single-practice PCNs have registered patient lists within NHS England’s preferred size of PCNs, of 30,000 to 50,000 population.
There are 27 that lie within these bounds – characterised as a “hard bottom and soft top” by NHS officials in the run up to the launch of PCNs in July last year.
Three are above the 50,000-patient upper limit – with the largest a little shy of 65,000. And there are eight under the 30,000 bound. The smallest is less than 25,000 patients.
The networks are collections of GP practices brought together last year to work collectively in networks providing services stipulated by a network contract from NHS England in addition to their general medical contracts.
It is not yet clear how pre-existing large-scale GP provider models will shape the development of the nascent PCNs — and whether more PCNs will develop into single large providers. HSJ’s analysis of PCN data shows how examples of two existing models of at-scale provision are distributed across the networks.
Large-scale GP providers
These providers — often known as super-partnerships — are various forms of entities made up of tens or hundreds of GPs, often working as GP partners but in a more corporate entity, caring for hundreds of thousands of patients but divided into individual constituent practices and practice lists.
HSJ has isolated the 12 largest of these at-scale providers, which have nine or more constituent practices not counting urgent care centres and other services that are not core members of a PCN.
These super-partnerships are involved in 141 PCNs – around 11 per cent of the total – according to data collected by HSJ using freedom of information laws from clinical commissioning groups.
The second-largest, Our Health Partnership, with 38 GP practices spread across Birmingham and the West Midlands, has practices in 16 PCNs. For eight, half or more of the patients are from OHP practices. And in nine of those networks, half or more of the practice that are part of those PCNs are from OHP. It makes up the entire network in two of those PCNs.
Modality Partnership, the largest at-scale provider, is in 18 PCNs and has the majority of either practices or patients in seven of them, according to data collected by HSJi. There are three PCNs which are entirely made up of Modality practices.
The other seven super-partnerships with nine or more member practices have a majority of practices in three PCNs and contribute the majority of patients in three of them.
One, Centene, also known as Operose or The Practice Group, part of the large US -based healthcare firm, has 12 practices spread across 11 PCNs and contributes neither the majority of practices or patients in any of them. Centene is one of three major corporate health firms that provide primary care services in England.
The other two, Virgin Care and Care UK, are involved in PCNs but, like Centene, their practices are distributed across PCNs, without any making up the majority of practices or patients.
|Total practices (minus urgent care centres etc)||PCNs with at least one practice||PCNs made up entirely of this provider||PCNs that this provider contributes a majority of the collective list||PCNs that this provider contributes a majority of the practices|
|Our Health Partnership||38||16||2||8||9|
|The Village Surgery||11||10||0||0||0|
|Hurley Clinic Partnership||10||8||0||2||0|
|GTD Primary Care||9||6||0||0||0|
|Hope Citadel Healthcare||9||6||0||1||0|
|Symphony Healthcare Services||9||5||1||1||1|
Single practice networks
HSJ has also analysed the distribution of large-scale single practices. There are 60 with patient lists of more than 30,000, the lower end of the recommended range of populations PCNs are expected to cover.
Exactly half of these 60 practices are sole members of a PCN. However, the size of these practices is not an indicator of whether they have formed a PCN single-handed.
Octagon Medical Practice, the largest single patient list in England with nearly 85,000 patients, formed from a merger of three practices in Cambridgeshire and Peterborough CCG, is one of two practices in its PCN. However, it has 90 per cent of the near-95,000 patients in the PCN on its list.
The largest single-handed PCN is Midlands Medical Partnership, or MMP, which has nine branches in the Birmingham and Solihull CCG.
Of the 60 practices that come in above the expected minimum of 30,000 patients in a PCN, the smallest single-hander is Newgate Medical Group, in the Bassetlaw CCG, with a patient list just shy of 30,500.
However, there are eight single-handers below the minimum end of NHS England’s’ preferred size range for PCNs. They range in size from the Blandford PCN in Dorset of 24,818, made up of the White Cliff Group of two practices, to the Aspen Medical Practice’s Aspen PCN in Gloucestershire.
|Primary care network *NB: PCN names are being revised and may have changed||Patient list size||Constituent practice name||Home CCG|
|MMP Central and North||64874||Midlands Medical Partnership or MMP (with branches: All Saints Medical Practice, Broadmeadow Clinicl, Dudley Park MC, Old Priory Surgery, Stratford house Surgery, Erdington MC, Jockey Road MC, Mere Green Surgery, Kingsmount MC, Eaton Wood MC)||NHS Birmingham and Solihull CCG|
|Bay Primary Care Network||53750||Bay Medical Group||NHS Morecambe Bay CCG|
|Sutton Group Practice||51618||Sutton Coldfield Group Practice||NHS Birmingham and Solihull CCG|
|Hereford City HMG||47591||Hereford Medical Group||NHS Herefordshire CCG|
|Teldoc||46769||TELDOC||NHS Telford and Wrekin CCG|
|Sheppey||46768||Sheppey Healthy Living Centre||NHS Swale CCG|
|YMG||44088||York Medical Group||NHS Vale of York CCG|
|Portsdown||43998||Portsdown Group Practice||NHS Portsmouth CCG|
|Acorn Health Partnership||43361||Acorn Health Partnership (formerly: Gillies and Overbridge Medical Partnership, The Hackwood Partnership and Camrose Medical Partnership)||NHS North Hampshire CCG|
|Granta||43217||Granta Medical Partnership||NHS Cambridgeshire and Peterborough CCG|
|Beacon Medical Group||43092||Beacon Medical Group||NHS Devon CCG|
|Grafton Primary Care Network||41678||Grafton Medical Partners||NHS Wandsworth CCG|
|University Network||41499||University Health Service Health Centre||NHS Sheffield CCG|
|Whitstable PCN||40296||Whitstable Medical Practice||NHS Canterbury and Coastal CCG|
|GPS Healthcare||40139||GPS Healthcare (including branches: Meadowside, Park Surgery, Blythe Practice, Village Surgery, Yew Tree Practice)||NHS Birmingham and Solihull CCG|
|Bridge View PCN||37463||Bridge View Medical||NHS Bristol, North Somerset and South Gloucestershire CCG|
|Newcastle Central Health||37258||Saville||NHS Newcastle Gateshead CCG|
|Carlisle Healthcare||37069||Carlisle Healthcare (merged from: Brunswick House Group Practice, North Carlisle Medical Centre and St Paul’s Meidcal Centre)||NHS North Cumbria CCG|
|Colchester Medical Practice||36331||Colchester Medical Practice||NHS North East Essex CCG|
|Gosport Central||35891||The Willow Group||NHS Fareham and Gosport CCG|
|Holderness||35722||Holderness Health (merged from: South Holderness Medical Practice, Hedon Group Practice and Church View Surgery)||NHS East Riding of Yorkshire CCG|
|Middlewood Partnership||33576||Bollington Medical Centre||NHS Eastern Cheshire CCG|
|Surrey Downs PCN – Integrated Care Partnership||33088||Integrated Care Partnership||NHS Surrey Downs CCG|
|Tyntesfield Medical Group||32696||Tyntesfield Medical Group||NHS Bristol, North Somerset and South Gloucestershire CCG|
|University||31313||University||NHS Berkshire West CCG|
|Mayflower||31158||Mayflower Mannamead Surgery||NHS Devon CCG|
|Claypath & University||31157||Claypath & University Medical Group||NHS North Durham CCG|
|St Austell Healthcare||31043||St Austell Healthcare||NHS Kernow CCG|
|Sittingbourne East||30736||Memorial Medical Centre||NHS Swale CCG|
|Newgate Medical||30442||Newgate Medical||NHS Bassetlaw CCG|
|Aspen||29465||Aspen Medical Practice||NHS Gloucestershire CCG|
|Westongrove Partnership||29454||Westongrove Partnership||NHS Buckinghamshire CCG|
|Frome||29238||Frome||NHS Somerset CCG|
|Yateley||28020||Oakley Health Group||NHS North East Hampshire and Farnham CCG|
|Sittingbourne West||28007||Grovehurst Surgery||NHS Swale CCG|
|Living Well PCN||27713||LIVING WELL PARTNERSHIP||NHS Southampton CCG|
|Heart of Bath||26961||Heart of Bath (made up of multiple merged practices, including Oldfield, St James’s - which itself was formed from a merger with Catherine Cottage.||NHS Bath and North East Somerset CCG|
|Blandford Primary Care Network||24818||White Cliff Group Practice (Dr Evans and Partners) (which merged with Eagle House)||NHS Dorset CCG|
Data collected by HSJ
August to October 2019