Commissioning and funding general practice

Making the case for family care networks
The King's Fund, London W1G 0AN
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About this event

About this event

This session will focus on the future of primary care drawing on The King's Fund's recent report, Commissioning and funding general practice: making the case for family care networks. The report argues that current contracts for primary care services will not deliver the changes needed in the future. A new approach is advocated by the authors in which funding for general practice is brought together with funding for other services provided in the community as well as some hospital services. The aim would be to strengthen the role of GPs first and foremost as providers of care rather than as commissioners.

Federations of general practices would be offered the opportunity of taking on population-based capitated contracts to enable them to put in place new models of primary care and integrated services in the community. These services would be available 24/7 where appropriate, in order to provide alternatives to hospitals and ensure a rapid response to patients in crisis. By releasing resources from other areas of care, federations would be able to increase spending on general practices at a time when the NHS budget is not growing.

The authors define the key features of the new approach as including:

  • the contract focusing on outcomes of care and not inputs
  • providers demonstrating they have the capabilities to manage the contract
  • GPs working closely with specialists to provide care
  • providers taking ‘make or buy’ decisions on the use of budgets
  • commissioners working together to implement the contract
  • regulations supporting testing of the new contract.

If federations of practices are unwilling or unable to take on the new contract then NHS trusts should be given the opportunity to do so. A period of experimentation is needed in which federations of practices and NHS trusts are given permission to use the flexibilities available under the proposed contract to put in place the services required by an ageing population and the changing burden of disease.


Chris Ham

Chief Executive, The King's Fund

Chris Ham took up his post as Chief Executive of The King’s Fund in April 2010.

He has been Professor of Health Policy and Management at the University of Birmingham, England since 1992. From 2000 to 2004 he was seconded to the Department of Health, where he was Director of the Strategy Unit, working with ministers on NHS reform. Chris is the author of 20 books and numerous articles about health policy and management. He was awarded a CBE in 2004 and an honorary doctorate by the University of Kent in 2012.

Chris has advised the World Health Organization (WHO) and the World Bank and has served as a consultant to governments in a number of countries. He is an honorary fellow of the Royal College of Physicians of London and of the Royal College of General Practitioners, an honorary professor at the London School of Hygiene & Tropical Medicine, and a companion of the Institute of Healthcare Management.

Chris was a governor and then a non-executive director of the Heart of England NHS Foundation Trust between 2007 and 2010. He has also served as a governor of the Canadian Health Services Research Foundation and the Health Foundation.