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.
- Jon Sussex (PI- contact person)
- Manbinder Sidhu
- National Institute for Health and Care Research, Health Services and Delivery Research stream (NIHR HSDR) published report Vertical integration of GP practices with acute hospitals in England and Wales: rapid evaluation Dr Manni Sidhu, Jack Pollard, Jon Sussex; June 2022
- BMJ Open article: Manni Sidhu, Jack Pollard, Jon Sussex, January 2022 Vertical integration of primary care practices with acute hospitals in England and Wales: why, how and so what? Findings from a qualitative, rapid evaluation
- British Medical Journal article 3 December 2020 by Gareth Lacobucci: Vertical integration of hospitals and GPs has saved some practices but should not be imposed, study finds
- Blog by Manni Sidhu and Jon Sussex: The RAND blog 7 December 2020 Can Primary Care Networks and Models of Vertical Integration Coexist in the NHS?
- Blog by Manni Sidhu and Jon Sussex: Health Service Journal 1 December 2020 How hospitals could step in to manage GP practices
- Health Services Management Centre Development Workshop hosted by Manni Sidhu and Jon Sussex - Slide set on Vertical integration of GP practices with acute hospitals in England and Wales, October 2020
- Manni Sidhu, Jack Pollard, Jon Sussex, Acute hospitals managing general practice services in the UK: why, how and what are the consequences for primary care delivery? Health Services Research (HSR) UK Conference June 2020
January 2019- December 2020