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Next Steps to the Strategic Commissioning Framework – a vision for strengthening general practice

The Next Steps framework provides guidance and resources to support practices to develop high quality larger-scale general practice collaboration across London.

Developed in partnership with London Clinical Commissioning Groups, London wide Local Medical Committees (LMCs) and overseen by the Primary Care Clinical Cabinet, the framework aims to support practices across the capital to identify, create and build collaborative arrangements that work best for their local circumstances. It brings together learning from across London and shares flexible models for developing ways of working together that can be adapted to meet their needs to deliver primary care transformation.

Next Steps outlines two main types of collaborative arrangements between practices:

1. 
   

   Larger scale general practice models (LGPOs) Multiple practices work via formal collaborative arrangements so they can develop and train a broad workforce, as well as create shared operational systems and quality improvement approaches.

2. 
   

   Primary care networks (PCNs) Practices come together with community providers and the voluntary sector to serve smaller populations. The vision is to create multidisciplinary and team-based care for people with enduring, complex health and care needs.

Benefits for providers and commissioners

The benefits of collaboration for providers and commissioners include:

• shared knowledge and good practice
• greater resilience
• shared back-office support, training and skill development
• shared technology and resources,
• new roles,
• pooling of team members,
• combined purchasing power and ways to innovate and develop care and services (such as GP online services  and extended access).

Benefits for patients and practices

The benefits for patients are:

• More consistent and accessible care, delivered by a multi-disciplinary team with the combined skills to meets their specific needs.
• Care that is designed and delivered to suit their needs, provided by the right clinician, and accessed through a range of easy-to-use methods.
• Clinicians who are motivated, happy, effective and focused on delivering care rather than drowning in administration.
• The chance to be represented and involved in decisions relating to their care, have clear expectations of the service they receive, and can co-design changes to these services.
• Great care for life, from a joined-up, sustainable, high-quality, local network. This is thanks to new models of care and Integrated Care Systems with deep links to communities and a perspective that takes into account the whole population.

Benefits for practices are:

• A more fulfilling work life that lets them share expertise, work in a collaborative environment, use their specific skills, and spend more time on the things they were trained to do.
• A trusting, transparent workplace where they can constantly learn, where systems and processes are always improving, where the burden of administration is reducing, and where resources are used in the best way.
• Opportunities to develop professionally and personally, deepening and broadening skills and advancing their careers. They also get professional support when navigating clinical and non-clinical situations as well as information and expert advice to help them make decisions.
• A shared purpose and values, making them more engaged in the operations and development of the organisation, and more attuned to the broader care system. Skills and team members are shared between practices to deliver more personalised care to patients.
• Closer collaboration across providers. This gives them a more supportive, less isolated, multi-disciplinary approach, and lets them offer better care.

Collaboration in London

Collaboration is not new to general practice. In recent years, practices across the capital have been developing stronger relationships with each other and with other care providers. Almost every practice is now part of a larger scale organisation or federation.

Next Steps recognises that practices across London are at different stages of collaboration. The guidance includes a matrix of how to start, build upon or enhance collaboration locally. Providers and commissioners can identify where their practice is on the collaboration journey using the Next Steps guidance and tools.

Reading and resources

Next Steps to the strategic commissioning framework

Next Steps multimedia, templates and communications tools

Next Steps frequently asked questions

Next Steps maturity matrix and resource guide