So why is funding only going into huge neighbourhood teams?
For the past 15 years we have been telling NHS managers that GP partnerships are more effective and less costly than the alternatives, but they have tried again and again to introduce centralised solutions.
We have been soldiering on, looking after patients, expecting that as successive schemes fail, they will eventually see the evidence. But instead, they blame GP partnerships for their failure and say GP teams must go first.
But why do they think this? Are they stupid? Actually, NHS managers are usually quite bright, but the problem lies in the NHS management mindset.
They are trained that the only way to commission a service is through a lengthy bureaucratic process. They are told they should accept a less effective more wasteful solution if it avoids any risk they could be criticised. And because these solutions run on “pump priming” money they always look good to begin with.
No manager ever got fired for suggesting a more centrally controlled highly monitored service. That is where they are safe. Even if it is less good for patients.
Where are the teams that have survived 10 years and have gone through at least one cycle of retirement and replacement of their founders to emerge successfully with no extra cash needed? The only ones I know of are GP partnerships.
We should take a lesson from Mother Nature and use funding to replicate what has been shown to thrive.