Acute hospitals managing general practice services

This evaluation aimed to understand the early impacts of vertical integration

An infographic summarises the study and its key findings

Specifically, the evaluation aimed to understand;

  • the objectives of vertical integration
  • how it is being implemented
  • 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.


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.


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.

Project team

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


Project Duration

January 2019- December 2020