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Acute Hospitals Managing General Practice Services Phase 1

The National Health Service (NHS) in England is facing unprecedented pressures. Patients are experiencing long waiting times, difficulties accessing appointments, and fragmented care pathways. To address these challenges, innovative solutions are needed to improve the integration and coordination of primary and secondary care services. One potential solution is vertical integration, where acute hospitals or health boards take over the direct management of GP practices. This model of integration is gaining traction across the UK as a way to better connect the planning and delivery of primary and secondary services. However, the evidence base for vertical integration is limited, and there is a need for robust research to understand its impact on patient care, service delivery, and workforce dynamics.

Evaluation

The University of Birmingham's BRACE Centre is leading a rapid evaluation of vertical integration in the NHS. Our research aims to shed light on the objectives of vertical integration, how it is being implemented in different settings, and its impact on patient care and the wider healthcare system.

Specifically, the evaluation aimed to understand:

  • The objectives of vertical integration 
  • The different models of vertical integration being implemented across the UK
  • Whether and how vertical integration can drive the redesigning of care pathways
  • Whether and how services offered in primary care settings change as a result 
  • The impact on the general practice and hospital workforces

Background

Vertical integration, where acute hospitals or health boards take over the direct management of GP practices, has been outlined as one response to integrating the planning and delivery of primary and secondary services. There are several locations across the UK where acute trusts or health boards have taken over general practice contracts and are directly managing GP services, and are using this model of integration to redesign local services such as urgent care. Early impacts have been reported from one of these trusts, including a reduction in emergency hospital admissions and increasing access to GP appointments, but this has not been subject to independent evaluation. Beyond that, little is known about this model of integration. This project ran from January 2019 to December 2020. 

Our Approach

The study comprised of a scoping review of the existing UK and international research evidence on vertical integration; a workshop with policy makers and researchers to develop appropriate research questions; qualitative research with three case study sites; and follow up workshops with each site and policy makers to share findings.

The case studies included sites who have adopted three different approaches to directly managing GP practices across the UK.

Our Outputs

Outputs 

Our Team

  • Jon Sussex (PI- contact person)
  • Manbinder Sidhu