Mike Holmes is a GP in a large practice of 50,000 patients in York & Hull and part of a GP Federation covering 130,000. He is also the newly elected Vice-Chair, Membership of the RCGP. Furthermore Mike is a founder member of NHS Collaborate, the primary care leaders’ network developed by primary care leaders. In this episode Mike tells the story of how his practice grew across two cities, how the large GP federation emerged and what at-scale general practice has been able to deliver in York and Hull. In telling his story he outlines some important lessons about GP resilience and how it can be strengthened by increased scale.