NICS is the GP Federation in North West Surrey, which consists of 40 GP practices who have agreed to work together to improve access to primary care appointments for the benefit of our patients. With the combination of a growing population, people living longer and a higher than average elderly population managing multiple medical conditions, GP practices need to find more efficient ways of working so that we can continue to provide high quality care to our patients despite the growth in demand. The traditional primary care model is becoming increasingly unsustainable and it is important that we work together to protect and enhance the valuable services we provide as part of the NHS. The remit of a GP Federation is generally to share responsibility for delivering high quality, patient-focussed services for its communities. This can include developing services specifically to suit local needs which are more easily commissioned ‘at scale’ – i.e. across a number of towns/districts. This model, supported in NHS England’s Five Year Forward View, provides opportunities for economies of scale. This includes minimising duplication of effort on areas practices currently deal with individually such as back office functions and the procurement of practice services. It will also enable the development of centralised training and education.