How to make change happen in general practice

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Change can be difficult in any organisation and general practices are no different. The growing crisis facing general practice, where demand is outstripping available workforce, means that as integrated care systems (ICSs) take on responsibility for NHS resources, understanding how to make change happen and happen well in general practice is vital.

In the report Levers for change in primary care, commissioned by NHS England and published alongside the Fuller stocktake on primary care, we set out the findings from the published evidence on how change happen.

We’ve also created a short resource, How to make change happen in general practice, for general practices and ICSs setting out four principles drawn from this evidence to highlight how to make change happen.

  • Changes work best when they’re driven from the bottom up.
  • Financial incentives and targets can change activities, but that’s not the same as improving outcomes.
  • The ‘soft’ stuff is important.
  • People need capacity and capability to make change happen.

This resource was created with an awareness of the pressures the sector is currently under. For each of the principles, we describe why it matters, and what it might mean for those working in general practices and in ICSs.

How to make change happen in general practice

This short resource, for general practices and ICSs, sets out four principles to highlight how to make change happen.



Dr Malcolm Rigler

General Medical Practitioner,
Self Employed
Comment date
05 August 2022

During a period of poor health I reluctantly asked the GMC to remove my name from the GMC List. After just over 2 years my health had improved and I was able to have my name reinstated on the GMC List . However , unknown to me and without my approval or consent my name had been removed from the GP Performers List for England. I now find that it is very difficult / almost impossible to have my name put back on the GP Performers List for England . I would be happy to explain why this is so to anyone interested. I have spoken to other doctors in a similar position who , after a period "off sick" seek to return to practice but they find the hurdles to be too great !! Might The Kings Fund look into this situation and try to find a "fast track" for experienced GPs to Return to Practice?

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