Primary care federations toolkit

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As the coalition government moves forward with their plans for clinical commissioning, the Royal College of General Practioners (RCGP) commissioned an online resource to support GP practices forming federations.

Developed by The King's Fund in partnership with the RCGP, the Nuffield Trust and Hempsons Solicitors, this toolkit provides advice and support to practitioners and managers in primary care who are thinking about, or have already embarked upon, developing a federation to provide and develop services collaboratively.

Click here to view the toolkit

Find out more about the toolkit

Watch Candace Imison's presentation as she explains what benefits this online resource will have for GP consortia.

How was the toolkit developed?

This toolkit should provide an invaluable aid to practices seeking to federate in order to develop and enhance the quality of services for their patients.

The team, from The King's Fund, The Nuffield Trust and Hempsons solicitors, worked under the guidance of a steering group from the RCGP and an external reference group, that included front-line staff working within federations as well as other senior staff from across the NHS.

The toolkit content has been informed by the following:

  • an online survey of all members of the RCGP, carried out in May 2010, seeking views on federations and experience of working within them
  • a review of the international literature on GPs working in federations to identify what factors enable or obstruct federated working and what federations do well and less well
  • semi-structured interviews with those currently leading or working in a federation to explore and illuminate the different opportunities offered by federated working and how best to achieve these
  • expert legal advice from the lawyers within the project team
  • desk research on relevant policy and managerial best practice.

There is a strong focus on signposting practical resources developed by a wide range of management, academic, national and international experts. The toolkit also draws on the extensive research evidence about different forms of primary care-led commissioning as well as provision. This evidence promotes the importance of clinical engagement, management support infrastructure, governance and ownership.

What are the benefits of joining a federation?

The reasons why practices might choose to federate, include:

  • to strengthen clinical governance and improve the quality and safety of services
  • to develop training and education capacity
  • strengthening the capacity of practices to develop and tender for new services out of hospital
  • to make efficiency savings/economies of scale, for example in back office functions or the procurement of practice services
  • to improve local service integration across practices and other providers.

This toolkit aims to help practices fulfil each of these ambitions.

The development of federations

The concept of a primary care federation was first described by the Royal College of General Practitioners in September 2007 in its publication, The RCGP Roadmap. It described a model where practices would work together more closely to share resources, expertise and services either to commission and/or provide services.


Dr Audrey Boucher

GP (senior partner),
Whitchurch Surgery, Hants RG28 7AE
Comment date
27 November 2013
I was advised by a GP in another practice with whom we might federate to look at this on the Kings Fund website, but it's not here, it's on the RCGP website. Well that's fine. I'm not a member of the RCGP (even a GP training scheme was optional when I went in to general practice). I'll have to ask my partners to look for me.

Lucy Hall

Comment date
09 January 2014
The toolkit is accessible via the RCGP website without needing to sign in through the following link:

Martha Dibenedetto

Comment date
29 September 2016
Useful article ! I was enlightened by the facts . Does someone know where my assistant might be able to get ahold of a fillable GSA SF 1169 form to edit ?

madeleine sage

Comment date
30 September 2016
Hi Martha, my business partner got ahold of a sample GSA SF 1169 example using this

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