Acute hospitals managing general practice services (vertical integration) phase 2 - a rapid mixed methods impact evaluation

Our evaluation aims to understand the impact of vertical integration on secondary care service use and on patients’ experiences of accessing and receiving care, particularly those living with multiple long-term conditions.

An infographic summarises the study and its key findings

Specifically, the evaluation aims to understand:

  •  the extent of vertical integration between acute hospitals and GP practices that has already taken place in England
  • the impact on secondary care utilisation
  • the impact on the patient journey with regard to access to, and overall experience of, care
  • the impact on patients living with multiple long-term conditions he objectives of vertical integration

  

Background

Vertical integration, where acute hospitals take over the management of GP practices, is one response to integrating the planning and delivery of primary and secondary services. There are several locations across England where acute trusts have taken over general practice contracts and are directly managing GP services, and could this model of integration to redesign local services.

 In 2020, a BRACE rapid evaluation of vertical integration investigated the implementation of acute hospitals managing general practices, as well as addressing questions relevant to scaling-up this model of integration in an English NHS setting. Overall, the authors found that vertical integration helped sustain primary care by supporting practices experiencing financial and recruitment difficulties. In the follow-up, impact evaluation we expect to learn more about the effect this model of integration is having.

Approach

The study is comprised of: 1) review of NHS trust annual reports, relevant literature and data sets to understand the scale of vertical integration across England; 2) quantitative analysis of national secondary data to explore the impact of vertical integration on secondary care utilisation and the financial implications of that; and 3) qualitative data collection and analysis with key stakeholders and patients across three case study sites to understand the impact of vertical integration on experience of care. We will deliver workshops with each site and with policy-makers to share findings.

Project team

  • Jon Sussex (PI- contact person)
  • Manbinder Sidhu (PI - contact person)
  • Katie Saunders
  • Charlotte Davies
  • Fifi Olumogba

Outputs 

  • Watch Manni Sidhu (UoB) and Jon Sussex (RAND Europe) from the BRACE Rapid Evaluation Centre team present findings from a recent evaluation of hospitals providing general practice services. The presentation explores both the drivers and impact of this model of vertical integration, including in-depth findings from three case study sites in England. The passcode is v01Z%*VX 

Project Duration

March 2022 - January 2023

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