Being geographically defined though, there is a horizon to initial opportunities and many will not consider work beyond CCG boundaries.
However, federating with other federations to help integrate primary care with other organisations that work over a wider area may help exploit other opportunities. This could include:
Up-scaling management should not be hard as the decision-making infrastructure is in place for each federation.
Just as super-partnerships may re-define the delivery of primary care contracts, super-federations could do the same for contracts for services.