Realising the potential of primary care The role of general practice

This content relates to the following topics:

Highlights from this event

Chris Ham in conversation with Craig Tanio

Chris Ham speaks to Craig Tanio, Chief Medical Officer at ChenMed, about how the US-based primary care-led delivery model offers care to older patients with complex needs.

Watch the interview

Ingrid Brindle: a patient perspective on shared electronic health records

Patient Ingrid Brindle discusses the confidence, independence and security that she's gained from being able to access her GP electronic health records.

Watch the highlights of Ingrid's talk

Amir Hannan: representing patients and their families in the transformation of primary care

Dr Amir Hannan talks about the benefits of giving patients access to their full GP electronic health records, and about how this works at Haughton Thornley Medical Centres where over 3,000 patients have access.

Watch the highlights of Amir's talk


General practice is widely recognised to be the foundation on which the NHS is based. But practices are coming under increasing pressure with rising demands and expectations from patients who are presenting with chronic co-morbidities, in an increasingly difficult financial environment.

Managing these complex conditions requires a collaborative approach from services across primary and community settings with strong links to acute providers and specialist services. General practice must play a leading role in providing this integrated system of care that provides a high quality, co-ordinated range of services that meets the expectations of patients and their families.


Session one: Transforming primary care

Introduction and welcome
Professor Chris Ham, Chief Executive, The King's Fund

Representing patients and their families in the transformation of primary care
Dr Amir Hannan, GP, Board Member leading on long-term conditions, information management and technology and patient engagement/empowerment, Tameside and Glossop Clinical Commissioning Group
Ingrid Brindle, Patient

A vision for personalised, proactive care: the patient, financial and political imperatives for change
Chris Ham in conversation with:

  • Dr Nikita Kanani, GP, Quality Lead Faculty of Medical Leadership and Management and Vice Chair, Integrated Care Lead, NHS Bexley Clinical Commissioning Group, Board Member, National Assocition of Primary Care
  • Dr Amir Hannan, GP, Haughton Thornley Medical Centre
  • Professor Viv Bennett Director, Nursing, Public Health England and Director, Nursing, Department of Health

 Questions and discussion

Session two: Specialist general practice

Welcome back
Mike Farrar, Chief Executive, NHS Confed

Providing care to the sickest, oldest and poorest: a concierge service for patients
Dr Gordon Chen, SVP Medical Affairs and National Market Development, ChenMed
Dr Craig Tanio, Chief Medical Officer, ChenMed

Questions and discussion

Panel response: How can this kind of model be developed in the UK?

  • Dr Martin McShane, Director, Domain 2, NHS England
  • Professor Chris Ham, Chief Executive, The King’s Fund  
  • Robert Varnam, Head of General Practice Development, NHS England

Session three: Case studies

A. How can we reduced pressure on acute services while providing a better experience for patients?

Chair: Dr Nicola Walsh, Assistant Director, Leadership Development, The King’s Fund

Achieving vertical and horizontal integration: working with partners across primary, community, social and secondary care to provide a better level of service to patients
Sarb Basi, Managing Director, Vitality Partnership

Enhancing community care and specialist services – South Kent Coast (PM Challenge Fund)
Hazel Carpenter, Accountable Officer, South Kent Coast Clinical Commissioning Group and Thanet Clinical Commissioning Group

Together as one community: integrating primary, community and social services

Dr George Campbell, Vice Chair, NHS Hambleton, Richmondshire and Whitby Clinical Commissioning Group
Maddy Ruff, Managing Director, North Yorkshire and Humber Commissioning Support Unit

Questions and discussion

B. What kind of primary care health services for patients really want?

Chair: Professor Chris Ham, Chief Executive, The King’s Fund

Lessons from Bromley-by-Bow: how to provide the best deal for patients in the community
Dr Sam Everington OBE, Chair, NHS Tower Hamlets Clinical Commissioning Group and GP, Bromley-by-Bow

Innovative approaches to providing better access to services: empowering patients to take control
Dr Arvind Madan, Partner and CEO, The Hurley Group

EPiC - Extended Primary Integrated Care: Working together to a healthier future
Dr Jonathan Serjeant, GP and Clinical Director, Brighton and Hove Integrated Care Service

Session four: Investing in primary care

Welcome back
Professor Chris Ham, Chief Executive, The King's Fund

Population-based capitated budgets: making the case for family care networks
Rachel Addicott, Senior Fellow, Health Policy, The King's Fund

Panel response:

  • Dr Rebecca Rosen, GP and Senior Fellow, Nuffield Trust
  • Dr Maureen Baker, Chair, Royal College of General Practitioners (RCGP)
  • Dr Chaand Nagpaul, GP and Chair, BMA General Practice Committee


Professor Chris Ham

Chief Executive, The King's Fund

Read Chris's biography

Dr Amir Hannan

GP, Haughton Thornley Medical Centre

Amir is a GP at Haughton Thornley Medical Centres in Hyde and a board member for NHS Tameside and Glossop CCG leading on long-term conditions; information management and technology; and patient engagement and empowerment. He is also a member of the Clinical Leaders Network.

Developing a 'partnership of trust' between patient and clinician, the practice has enabled more than 2,300 citizens (20 per cent) to access their GP electronic health record online, helping them to self care and gain a better understanding of their health. He has set up an innovative practice-based web portal for his practice, putting patients, managers and clinicians at the heart of health care, giving them a feeling of more control and enabling real-time digital medicine.

Twitter: @amirhannan.

Sarb Basi

Chief Operating Officer, Vitality Partnership

Sarb has spent most of his working life in the NHS, working in Sunderland and extensively across the West Midlands. He has experience of working in a variety of roles including finance; contracting and planning; commissioning and primary care in acute and community trusts; FHSAs; health authorities; primary care groups, and a teaching primary care trust.

Sarb has spent the past four years working in the commercial sector on transforming the general practice sector. He has set up two 'super partnerships' and was the driving force behind a new commercial business supporting GPs with their business development requirements.

He joined the Vitality Partnership in December 2012 as chief operating officer and has set out a five-year strategic business plan to develop the very first large-scale integrated care organisation based on general practice in Birmingham.

Sarb's qualifications include a BA(Hons) in economics and a master's in social sciences (health care policy and management) from the University of Birmingham. 

Professor Viv Bennett

Director Nursing, Public Health England and Director, Nursing, Department of Health

Viv was appointed as the Department of Health's Director of Nursing and the Government's Principal Advisor on Public Health Nursing in January 2012. She provides high-quality and independent nursing advice to ministers and officials on policy issues and public health nursing. She leads the national Health Visiting Programme and School Nurse Development Programme. As of September 2012, Viv was also appointed Director of Nursing for Public Health England.

She trained as a nurse in Oxford in 1976 and worked in children's nursing before training as a health visitor in Oxford in the early 1980s. She worked as a health visitor and research health visitor in Oxford whilst studying for a BA and then Masters degree in health and social policy.

Dr Rebecca Rosen

GP and Senior Fellow, Nuffield Trust

Rebecca is a Senior Fellow in Health Policy at the Nuffield Trust and a General Practitioner in Greenwich. She is also an accredited public health specialist. Her current policy interests include integrated care, primary care, new organisational models for general practice and NHS commissioning.

Rebecca is a clinical commissioner in Greenwich Clinical Commissioning Group – where her lead areas are long-term conditions and quality.

Within her GP practice, Rebecca leads work to improve continuity and quality of care for people with chronic, complex ill-health and to apply the principles of the chronic care model in a practice setting.

In the past, Rebecca has worked as Medical Director of Humana Europe, as a Senior Fellow at The King's Fund and in NHS and academic public health departments. Past research interests include the diffusion of new medical technologies, patient choice and primary care policy.

Dr Chaand Nagpaul

GP and Chair, BMA General Practice Committee

Chaand has been a GP for the past 23 years and is a senior partner in his practice in Stanmore, North London. He has been a member of the General Practitioners Committee (GPC) since 1996, during which he has sat on 11 different committees and chaired two of them. He became a UK Negotiator in 2007 and was elected Chairman of GPC in July 2013. He has been a Local Medical Committee (LMC) member for over 20 years and vice-chairman for the past 12. Chaand is a BMA Council member, a member of its Political Board, as well as being Honorary Secretary of his local BMA Division.

Dr Maureen Baker

Chair, Royal College of General Practitioners (RCGP)

Maureen joined NHS Connecting for Health in 2007 and is now Clinical Director for Patient Safety. She has previously held appointments with the National Patient Safety Agency, NHS Direct and the University of Nottingham. Maureen was Honorary Secretary of the Royal College of General Practitioners (RCGP) from 1999-2009. Her work in patient safety includes establishing a formal clinical safety management system for NHS CfH, the development of safety standards for Health IT for the NHS in England and the development of e-learning modules on patient safety for doctors in training. She was elected as Chair of Council, RCGP, and started in November 2013

George Campbell

Vice Chair, NHS Hambleton, Richmondshire and Whitby CCG

George is the Deputy Chair and a GP governing body member of the CCG, with responsibility for planned care and mental health. He has worked in Whitby as a GP for the last 22 years in a large practice with nine whole time equivalent GPs, with a significant involvement in Whitby Community Hospital. The practice covers the minor injuries unit and have in-patient beds for palliative care and step up care. He is a  GPwSI and hospital practitioner in dermatology.

George has been involved in clinical management for some years. He has in the past been a non executive director of the old North Yorkshire Health Authority, a fund holding clinical lead and chair of a practice based commissioning consortium. More recently, he was deputy chair of the clinical executive of NHS North Yorkshire & York.

Maddy Ruff

Managing Director, North Yorkshire and Humber Commissioning Support Unit

Maddy has more than 20 years' NHS experience, having held a variety of board-level positions, including Director of Primary Care at Hambleton and Richmondshire PCT, Executive Director of Commissioning and Service Improvement for NHS Hull and Executive Director of Commissioning Development for the NHS Humber Cluster.  Her experience of and keen interest in primary care gives her a deep insight into the challenges and opportunities for general practice, and she believes the next two years will see radical change in the primary care landscape.

Yorkshire and Humber Commissioning Support is already supporting a number of practices across the region to come together at greater scale in order to overcome the challenges they currently face, whilst also enabling them to improve patient access and provide a wider range of services. This has included the development of GP federations, alongside support for service transformation, IT, and communications and engagement.

Hazel Carpenter

Accountable Officer, South Kent Coast CCG and Thanet CCG

Hazel is the Accountable Officer for both Thanet CCG and South Kent Coast CCG. As a non-clinician she sees her role as that of supporting the Clinical Chairs in their leadership role, ensuring that the Governing Bodies are able to make strong commissioning decisions for their local populations.

Hazel joined the CCGs prior to their authorisation in 2013. She has a keen interest in organisation design and development and has worked with the clinical chairs and membership to develop a culture and approach for each CCG that focuses on the local health and care challenges, as well as enabling real integrity for the clinical leadership and membership characteristics of a CCG.

Hazel leads LAC and Adoption health commissioning on behalf of all the CCGs in Kent, a reflection of the priority of LAC children for the Thanet community.

Prior to this role, Hazel worked across the NHS in Surrey and Kent in both provider and commissioning roles focusing on workforce and OD. She also led commissioning for maternity services across east Kent from 2007 to 2011.

Educated at the University of Leicester and the University of Manchester, Hazel has a BA in Geography - which is invaluable as a strong background for health planning, and an MSC in strategic HR leadership. With Dr Darren Cocker, Clinical Chair for SKC, she was awarded the post grad deans GP education award in 2010 for establishing the GP Integrated Training Programme for commissioning.

Dr Sam Everington OBE

Chair, NHS Tower Hamlets Clinical Commissioning Group and GP, Bromley-by-Bow; Trustee, The King's Fund

Read Sam's biography

Dr Arvind Madan

Partner and Chief Executive, The Hurley Group

Arvind has been a GP for 18 years and is the CEO of the Hurley Group. The Hurley Group is an NHS GP practice that has grown from a single surgery in a deprived part of South London, into being one of UK's larger providers of GP and urgent care services, over the past seven years.

After initially leading on operations, he has led on strategy for the Hurley which now runs 18 practices caring for over 100,000 registered patients and it operates 10 urgent care services seeing 350,000 patients a year. He has also led on setting up a variety of new clinical services, pharmacies and premises developments.

He is currently leading on two flagship projects for the Group - the first is providing online services for patients, and the second allows GPs to remotely crowd source advice from each other and specialists. He is member of the Kings Fund Advisory Group and a Director for a community interest company that runs peer mediation for 30 London schools.

Jonathan Serjeant

GP and Clinical Director, Brighton and Hove Integrated Care Service

Jonathan is a GP partner and health care entrepreneur who works with people to find a better solutions to our current health care systems.

He is Executive Director/co-founder of Brighton and Hove Integrated Care Service (BICS). This not-for-profit social enterprise exists to transform care from 'what's the matter?' to 'what matters to you?' BICS achieves this through developing pathways of care that support people to be in control of their healthcare, and supporting general practice to collaborate to be part of the sustainable solution in their local health community.

Since the beginning in 2008 BICS has grown from four people to more than 250 employees. BICS has led the on the delivery of prime contracting in musculoskeletal, wellbeing, and dermatology services, and has recently won over £400 million MSK contracts in Sussex.

Jonathan led the bid and visioning of EPiC (Extended Primary integrated Care), a successful Prime Ministers Challenge fund bid. BICS underpins the design and implementation of EPiC across 18 GP practices and 20 pharmacies in Brighton.

Jonathan is also a founder and director of Medical Imaging Partnership, GPnetworks, Optymalhealth consultancy and an NHS Alliance Executive Team member.

Rachael Addicott

Senior Fellow, Health Policy, The King's Fund

Read Rachel's biography

Dr Nikita Kanani

GP, Quality Lead Faculty of Medical Leadership and Management and Vice Chair, Integrated Care Lead, NHS Bexley Clinical Commissioning Group, Board Member, National Assocition of Primary Care

Nikita is a GP in South East London and CCG Vice-Chair, where she is responsible for Integrated Care, Primary Care Commissioning, Clinical Leadership and Patient/ Public Engagement. She is also the National Quality Lead for the Faculty of Medical Leadership and Management and incoming Honorary Secretary of the National Association of Primary Care. She is passionate about improving service provision and population health within the NHS and has managed and taken the lead on numerous projects that reflect this.

She has been CCG Lead for Community Clinics and Diabetes, Medical Adviser for NHS Direct, Clinical Lead for a large Community Provider Trust, PCT Lead for Winter Planning and Screening Assurance, and Service Modernisation Lead for an Acute Trust. In the latter role she was responsible for managing a number of key projects designed to improve patient flow and experience, including the whole scale redesign of Emergency Care and implementation of a discharge facilitation team in the community.

Nikita is Co-Founder of The Network, an RCGP Clinical Commissioning Champion, and committed to developing clinical leadership in the rapidly changing Primary Care landscape. She is currently working towards an MSc in Healthcare Commissioning, has a Post Graduate Certificate in Managing in Health and Social Care, a HFMA Certificate in Healthcare Finance, is a PRINCE2 Practitioner and ‘Lean’ trainer, a recipient of the NHS London ‘Prepare to Lead’ scheme and holds a DRCOG and DFSRH.

With her astrophysicist sister, she set up STEMMsisters (@STEMMsisters), an enterprise which aims to inspire and empower people from disadvantaged backgrounds to study ‘STEMM’ subjects and access mentoring and coaching opportunities.

Dr Tim Wilson

Partner, Health Industries, PricewaterhouseCoopers LLP

Tim is a partner in PwC's Government & Public Sector practice. He has over 20 years experience of working across the NHS and has led projects in commissioning, patient experience, improving clinical research and quality, cost efficiency and transformation.

Before joining PwC, Tim worked at the Department of Health Strategy Unit as a senior policy analyst, advising on the reform of community and primary care, and commissioning. Tim also continues to practise as a family doctor and has published extensively on quality and safety issues in health care.

Dr Gordon Chen

SVP Medical Affairs and National Market Development, Chenmed

Gordon is the Senior Vice President of ChenMed, a Florida-based national primary care delivery system which focuses on delivering high-value care to seniors in under-served areas. He leads the medical services for the South Florida division, national business development and specialist service lines. He has led the physician recruiting and physician training and development aspects of ChenMed's national expansion and also has interests in health care innovation and technology as it applies to health care delivery and co-ordination of care. 

Gordon enrolled in Brown University's Program of Liberal Medical Education before accepting a scholarship to attend University of Miami School of Medicine. He continued his fellowship in Cardiology at Miami where in his last year, he was elected Chief Fellow and awarded outstanding fellow of the year. Since formally joining ChenMed in 2011, Gordon has helped ChenMed expand from six to 36 medical centres, along with hiring and training over 100 providers to ChenMed’s unique value-based health care delivery system. He is also President of Nicaragua Medical Missions.

Dr Craig Tanio

Chief Medical Officer, Chenmed

Craig is the Chief Medical Officer of Chen Med, a Florida-based national primary care delivery system which focuses on delivering high-value care to seniors in under-served areas. The group accepts full global risk from Medicare Advantage health plans and has created a comprehensive approach to integrated care that incorporates multiple delivery system innovations ranging from an emphasis on strengthening a physician culture of accountability to on-site physician prescription dispensing to smaller patient panels to a customized information technology. They also have developed a joint venture with Humana called JenCare Neighborhood Medical Centers which has grown to 25 centres in six cities in the south east.

Craig was formerly a partner at McKinsey and Company, where he helped multiple payors, providers and international health systems develop and implement strategies to better manage health care costs and improve quality. He also worked as the Chief Operating Officer of Baltimore Medical System, one of the largest U.S. federally qualified community health centres dedicated to delivering healthcare to the uninsured. Craig currently serves as the Chairman of the State of Maryland's Health Care Commission, a regulatory body focused on improving health care quality, information and access in the backdrop of Maryland being the first state in the US that has committed to managing the health economy under a global budget. He is also a member of the Governor's Health Reform Coordinating Council.

Craig holds appointments as Assistant Professor of Medicine at the Johns Hopkins University School of Medicine and Senior Scholar in the Department of Health Policy of Jefferson Medical College. He received an MD from the University of California, San Francisco, an MBA from the Wharton School and a BA in Political Science from the University of California. He did his internal medical residency at the University of Pennsylvania where he was chief medical resident and a Robert Wood Johnson Foundation Clinical Scholar. He is board certified in internal medicine and actively practices medicine.

Dr Martin McShane

Director, Domain 2, 'Improving the quality of life for people with long term conditions', NHS England

Martin qualified as a doctor in 1981. He trained in general and vascular surgery before electing to enter General Practice. From 1990 until 2004 he was a GP partner in a training practice.

He has previously chaired a Primary Care Group and Professional Executive Committee and was Chief Executive of North Eastern Derbyshire Primary Care Trust from 2004-2006. From 2006-2012 he was Deputy Chief Executive and Director of Strategic Planning and Health Outcomes for NHS Lincolnshire as well as a member of the National Patient Safety Forum and Vice Chair of East Midlands Specialised Commissioning Group.

He was appointed his new role within the Medical Directorate of NHS England in 2012.

Robert Varnam

Head of General Practice Development, NHS England

Robert is a GP in inner-city Manchester. At NHS England he contributes to primary care and commissioning strategy and supports communities of innovation. As a GP in a large practice, Robert has led a large multiprofessional team and pioneered improvements in quality, safety and patient experience. He has broad experience of leadership in the local NHS, through roles in PCT leadership, practice based commissioning, service redesign and public health. Robert's research at the University of Manchester employed both epidemiological and sociological perspectives on quality and safety. His PhD examined patient safety in general practice from the patient’s perspective.

Robert has established development programmes on improving quality and safety in primary care at the NHS Institute for Innovation and Improvement and NHS Improving Quality. He is a well-known speaker at national and international events on out of hospital care and improvement.

Robert co-chaired the NHS Future Forum integrated care programme, and has been at the heart of national work to support the development of CCGs. At the Royal College of General Practitioners, he helped to establish the Centre for Commissioning and led the roll-out of the Practice Accreditation scheme for general practice. He established the CCG transformational change programme at NHS Improving Quality.

In his role at NHS England, he provides input on system transformation, commissioning and primary care development. He is leading a programme to describe a vision for future models of primary care and identify strategic opportunities to drive change. He designed the development and evaluation programme for the Prime Minister's Challenge Fund on access and is the leading a new development programme to support adoption of new proactive care models in general practice.