To what extent are twenty first century General Practitioners entrepreneurial when delivering primary care services in new ways?

  • Michael Spence

Student thesis: Master of Philosophy


Traditionally, General Practitioners (GPs) in England are self-employed contractors, who work in combination with other GPs as profit sharing partners (Lester, Campbell, & McDonald, 2009). The introduction of The Health and Social Care Act (The Department of Health, 2012) and a move towards 'any willing provider', creates opportunities for GPs and an increasing necessity to focus on their business interests. However, the NHS is facing extreme financial and capacity pressures, largely due to the expanding and ageing English population (Addicott & Ham, 2014). Hence, this study focusses on the provision of 'new services' within primary care, whilst exploring the extent to which GPs are required to be entrepreneurial, to provide such services. A review of the literature revealed a substantial amount of empirical work around economic entrepreneurship theory; however, identifying a universal definition of entrepreneurship was difficult to decipher. Due to the contextual and political influences present within the primary care NHS market place, and identification that entrepreneurial working can create 'new value', this study has utilised the work of Rae (2007b) and his model of entrepreneurial management. However, the literature review revealed that there was minimal empirical work on entrepreneurial working within the primary care NHS context. Although two key papers focussing on GP Fundholding and entrepreneurial working were identified, namely Boyett & Finlay (1995) and Ennew, Whynnes, Jolleys, & Robinson (1998). A case study approach was taken, relying largely on face to face interviews with practitioners involved in the delivery of new services within primary care. A purposive sampling method was used, with data collected from four different localities. Data analysis was performed using a paper based approach akin to Smith & Osborn (2003), with themes and sub-themes developed from the data.The results of this study identify that on the whole, participants were entrepreneurial in the delivery of new services. The data express that differences exist within the extent to which participants were entrepreneurial. In terms of the motivations to deliver new services, 'improved patient care' was seen by all participants as being a key motivator; however a number of others such as 'financial gain', 'career development' and 'clinical expertise' were identified by participants. The results of this study also outline the importance of being 'alert' to opportunities that present themselves, with participants expressing that both formal and informal relationships with the local commissioning group were advantageous.
Date of Award1 Aug 2016
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorRuth Boaden (Supervisor) & Lynn Sheppard (Supervisor)


  • Hybridity
  • GPs
  • Entrepreneurship
  • NHS
  • Entrepreneur
  • Primary care
  • Innovation

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