Wessex Local Medical Committees seminar

GP Federations The Nuts and Bolts Mary Chant - partner

Where do Federations Come From?

Federation - OED
A group of states with a central government but independence of internal affairs

Federations - RCGP
A primary care federation is an association of general practices and community primary care teams that come together to share responsibility for developing high quality, patient focused services for their local community.
Primary Care Federations Putting Patients First - RCGP June 2008.

Federations – “selling points”
Training primary care workforce
Continued viability of primary care
Economies of scale
Bid for primary care contracts
More efficient use of buildings
Build on practice based commissioning

Federations – key features
High calibre management
Improved governance
Combine back office functions
Improvements for patient care and safety
Internal referrals
Specialist employees

RCGP - Result
In essence, the ability to do more and achieve more for less

Federation Structures
No blueprint – flexibility
Loose arrangements perhaps with simple agreement
Highly structured entity
Variations in between

Governance

Accountability

To federate or not – that is the question
What do you want to achieve
How can you achieve it in practice
Who do you need to associate with
Then consider what sort of structure you need

Business Structures
Contractual
Partnership
Company
Limited by shares
Limited by guarantee
Limited Liability Partnership

Contractual
No formal structure created
Contract - who does what, who gets what
May be a need for a Lead Body
Big group / complex delivery - harder to make this work

Partnership
Carrying on business in common with a view to profit
Partnership Act 1890

LLP
Cross between partnership and company
Features of a partnership
But has limited liability
Taxed as a partnership

Company structure Company Directors (management) Shareholders/ Members (owners)

A Legal Entity Creditors Debtors Equipment Contracts With Specialist providers Contracts with Suppliers Contracts (PMS/ GMS/ APMS) Staff Company

Shares or Guarantee
Purpose of company?
Share capital
Not for profit / charitable purposes
Realise investment

Shareholders Agreement
Relationship between shareholders
Alters balance of power
Resolution of disputes
Exits

Directors’ Duties
Statutory duties
Fiduciary duties

Company Administration
Annual filings and actions
Event driven filings

Which Structure?
Legal restrictions (GMS Regulations)
Goodwill
Pensions
Taking on contracts

Wessex Local Medical Committees seminar

by Blake Lapthorn on Sep 20, 2010

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Wessex Local Medical Committees seminar — Presentation Transcript

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