2. The Burning Platform
Evolving a New Model for
General Practice
Financial
Constraint
Workforce
Crisis
Increasing
Demand

5. How many patients are registered with the Hurley Group?
15,000
20,000
25,000
31,000
41,000
55,000
75,000
95,000
2006 2007 2008 2009 2010 2011 2012 2013
6.3
times
increase

6. How many minor illnesses and injuries do we treat a year?
35,000
130,000
140,000
180,000
205,000
2006 2007 2008 2009 2010 2011 2012 2013
4,615
a week

7. 25
35
55
100
170
210
232
272
2006 2007 2008 2009 2010 2011 2012 2013
How many in our team?

8. 2.5%
4%
2%
1%
11
%
4%
4%
11%2%
59%
40%
25%
29%
% of
borough’s
urgent care
% of
borough
registered
with Hurley

9. es
Our growth strategy working?
Pub
Hea
Contract
Reviews
Recruitment
Issues
Low Morale
Cuts
Practice
Failures
Revalidation
KPIs
PCT
meltdown
Rising Patient
Demand
Increasing
Regulation
Values
CQC
Rising Patient
Demand
Reduced
Funding
NHS
Reforms
PMS
Reviews

13. Network Services in the new financial year
1. Diabetes (Care Package) 9. Cancer screening (NEW)
2. NHS Health Checks (Care Package) 10. Healthy Lifestyles (NEW)
3. Imms and Vaccs (Care Package) 11. Sexual Health (New)
4. Hypertension 12. Anti-coagulation (enhanced)
5. CVD: Secondary Prevention (New) 13. Minor surgery & Aftercare (enhanced)
6. COPD (New) 14. Phlebotomy (enhanced)
7. PBC (redesigned) 15. Vulnerable Adults (New)
8. Drug and Alcohol (New) 16. Children 0-5 (New)
Docklands
Medical
Centre
Barkantine
Island
Medical
Island Health
Healthy
Island
Partnership

14. The 36 Tower Hamlets practices have formed 8 geographic networks 14
6
5
*
1
2
3
4
5
6
8 Health E1
9
10 Albion
LAP 2. Spitalfields and
Banglatown, Bethnal Green
South 8
9
10
7
LAP 1. Weavers, Bethnal Green North,
Mile End and Globe Town
1 Strouts Pl
2 Bethnal Green
3 Pollard Row
4 Blithehale
7 XX place*
5 Mission
6 Globe Town
11
12
15
13
16
14
11 Shah Jalal
12 Tower
13
LAP 3. Whitechapel, St.
Duncan’s and Stepney Green
14
Spitalfields
Varma
Stepney 17
18
19 Grove Surgery 22 St. Stephen’s
LAP 5. Bow West, Bow East
20 Tredegar
21 Harley Grove
23 Ruston Street
19
24
21
22
20
23
24 Merchant
Street
25 St Paul’s
Way
26
Stroudley
Walk
LAP 6. Mile End East, Bromley by Bow
27 Nischal
25
26
27
28
29
30
31
32
28 Limehouse 30 Chrisp St
LAP 7. Limehouse, East India Lansbury
29 Selvan 31
All
Saints
32 Aberfeldy
33 Barkantine 35 Island Health
LAP 8. Millwall, Blackwall and Cubitt
town
34 Docklands 36 Island Med Ctr33
34
35
36
17
St Katherine’s
Dock
18 Wapping
LAP 4. St. Katharine’s and
Wapping, Shadwell
16 Jubilee St
15 East One
LAP 4
LAP 3
LAP1
LAP 2
LAP 6
LAP 5
LAP7
LAP 8
7’
Bromley
by Bow
* Estimated registered population, calculated as ½ of Bromley-by-Bow and XX place combined list
Source: http://www.towerhamlets.gov.uk/data/in-your-ward; Allocation practice to LAP as per Team Analysis (Aug 2008); Number of
patients per practice based on LDP data (Jan 2009)

15. Grow to Survive
• Challenging financial climate
• Bigger is better for economies of scale
• Ability to flex resources across the whole organisation
• Ability to protect our teams more
• Maintain this critical mass as many contracts time limited
Grow to Invest
• People are our greatest asset
• Growth enables our nurturing talent programme
• Career progression opportunities for all
• Our ambition is to become London's employer of choice
Grow to Make a Difference
• Best care to the most deprived communities
• Being larger gives us influence
• Scope to innovate and develop Primary Care
Why Grow? Is bigger better?

16. The Journey?
General Practice is
sub-scale
Limited mechanisms to
enlarge to scale e.g.
procurement, M&A and
Federating
1. Have to do more with less
2. New skill mix and technologies
3. Commissioners Quality Conundrum
4. New models for true involvement
The roll
up to
come….
• Independents for
decades but….
• Enlarging Independent
Contractors
• The FT possibility
• Meaningful Federations