In the future, “family care networks,” with GP surgeries at their heart, should provide a wider range of services for patients outside hospitals, says health policy think tank The King’s Fund.

These networks would enable GPs to strengthen their role as providers and coordinators of care, in collaboration with other staff working in the community and some hospital-based specialties, it says, in a new report on the future of primary care.

NHS experts have long called for a shift in the way care is provided, with more services delivered closer to people’s homes, to meet the needs of an ageing population and the increasing numbers of people living with multiple long-term conditions. But, the report argues, most GP practices are too small to do this on their own; they need to work together in federations or networks to achieve the necessary scale.

The report proposes a new GP contract, to sit alongside existing arrangements, which would:

- fund a defined population (the registered list) which would be determined by a combination of population need and the range of responsibilities included in it, bringing together funding for general practice with funding for other services;

- require practices to link up with others to work at scale and benefit from pooled expertise and resources:

- be focused on the outcomes that providers would be expected to deliver under the contract, not on how to deliver them, offering providers greater freedom to innovate and collaborate; and

- facilitate a shift to proactively managing the health of their local population and responding quickly to patients in crisis.

This would encourage family care networks to provide a wider range of services than most general practices are currently delivering and to work with community nurses, health visitors, pharmacists and social workers to deliver all but the most specialised and complex care outside hospital. This should include out-of-hours care and ensuring that services are available 24/7 to meet urgent care needs, it says.

“This new funding and commissioning model for primary care could offer GPs an important opportunity to lead the way in finding new and innovative ways of working,” says Chris Ham, The King’s Fund chief executive and an author of the report.

“At a time when NHS budgets are increasingly under pressure and the proportion spent on general practice is in decline, these proposals could bring money into general practice if GPs take responsibility for providing and coordinating a wider range of services. GPs are well-placed to do this, but it would also be possible for trusts providing hospital and community-based services to take on the leadership role, working with GPs as partners,” he proposes.