London's single-handed GP practices will need to work in networks with larger practices in their area if they are to meet rising health demands in the capital.
A report by think tank The King's Fund urges practices to work with a wider range of health and social care professionals in order to gain better access to specialist and community services and work more "proactively" in reaching out to high-risk groups and tackling the wider determinants of ill-health.
It is claimed this will allow practices to deliver more integrated care to those with complex health and social care needs.
However, the report argues that the one in five single-handed practices in London and other very small GP practices will find it "difficult" to forge these relationships and encourages them to work in "networks" with other, larger GP practices in the area.
"By working in networks, smaller practices can retain their identity and knowledge of the population they serve, while also enabling the provision of services they would find difficult on their own," says the report.
Anna Dixon, director of policy at The King's Fund said the report paints a "pretty stark picture" of the challenges general practices in London face "in terms of diversity, mobility and in some cases quite bad deprivation" but by bringing smaller, more "isolated" practices in with other practices, she said they will be better placed to drive improvements for their patients and wider communities.
She also claimed the GP model redesign is "very much" linked with the health reforms that are currently underway.
"[The reforms] provide a great opportunity for practices to establish much stronger networks between other practices in their area as they become more engaged with clinical commissioning groups (CCGs)," she said.
"The links with CCGs will encourage practices to have greater partnership working with local hospitals, social services and local authorities."
Londonwide LMCs has delivered a damning verdict on the think tank's report and described its focus on practice model re-design "inappropriate" and "misleading".
It claimed a redesign of practice working will not improve existing health outcomes and called for a growth in recruitment of GPs and practice nurses and incentives to work collaboratively with other services in the community to drive improves in GP services.
"The report is too quick to jump to yet another system re-design solution, rather than building the positives and successes of the existing model, and how with the right support, improvements would deliver even better outcomes for the capital's patients – a strategy for which Londonwide LMCs has a clear vision to share," said Dr Michelle Drage, CEO of Londonwide LMCs.
Practices in Tower Hamlets and Wandsworth that have been forging "GP clusters" over the past five years were held up by Dixon as shining examples of the new practice model of working in a bid to improve and invest in shared services so even if patients are registered with a small practice, they can access the larger practices in the area.
"This model of working is already happening in London but what we are highlighting is that there is further to go," she said.