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Guide to practice mergers: Why we developed a super-partnership

Dr Dave Sangha and James Robinson explains how Midlands Medical Partnership has developed through mergers and its achievements.

Midlands Medical Partnership (MMP) is a Birmingham super-partnership that is leading the way in providing large-scale integrated primary care services. It is one of the largest GMS partnerships in the UK, caring for 62,000 Birmingham Cross-City CCG patients.

MMP’s vision is to provide responsive and high quality patient care, at larger scale, with integration of primary, secondary and community providers, whilst protecting the values of ‘traditional general practice’ in the changing NHS environment.

The super-partnership concept came from a discussion between like-minded GPs, with an ambition to protect local patients’ experience of primary care and develop improved access to services. Our goal in 2009 was to develop as a multispecialty community provider – something that has subsequently been developed as part of the NHS Five Year Forward View.

First steps

In 2009 the journey commenced with the merger of seven founder practices totalling 46,000 patients. This was driven by the GP partners, who developed a merger framework that has proved to be key to the formation of the super partnership structure.

There has since been three additional mergers and MMP now operates out of 10 sites across Birmingham, caring for nearly 10% of our CCG’s patients. Further growth of the partnership remains a key strategic objective. The partnership works with other local providers to improve the seamless provision of co-ordinated care, with centralised front and back office functions.

Our central management team has a general manager, operations manager and strategic business manager. We also have centralised IT, HR and finance functions. This means the local practices can focus on supporting patient needs, with integrated cross-site working, without the burden of organisational issues such as CQC, HR, IT and contracts.

Our achievements

Working at scale some of MMP’s achievements are:

  • Improved care co-ordination, increased access, increased services (primary and specialist) and single point of access for our patients    
  • Reduced costs from improved efficiency, allowing reinvestment to develop the organisation
  • In-house clinical support for all doctors and nurses, with structured educational and development programmes
  • Career development opportunities, with a well-organised HR function for over 200 staff.
  • Strength as a large scale provider to influence the outcomes for our organisation and patients
  • A corporate structure that provides more security for the partners and staff and has delivered forward thinking objectives and vision.

Working as a large provider has allowed us to develop a strong working relationship with Birmingham Cross-City CCG. MMP is the pioneer practice for the CCG’s Aspiring to Clinical Excellence Programme, which has integrated care as one of its key objectives. Our structure makes us ideally placed to implement an enhanced model of primary care.

Working at a larger scale as has been envisaged by the Five Year Forward View is an exciting journey. It has been well worth the effort. We believe MMP has set a benchmark for the ‘super-practice’ model, providing holistic, patient-centred care and more integration of primary, secondary and community services.

It is remarkable how the many steps along the way have combined to achieve such a substantial redesign of the model of primary care provision, helping to protect and secure the future needs of our patients.

  • Dr Dave Sangha is executive partner and James Robinson is general manager, Midlands Medical Partnership, Birmingham
Guide to Practice Mergers

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