Complex sentence: Perhaps the largest change was the movement from single doctor general practices to multiple doctor general practices, this was not a direct recommendation but rather because the report stated that there was not enough safeguarding and monitoring of doctors' decisions.
Split into simpler sentences: Perhaps the largest change was the movement from single doctor general practices to multiple doctor general practices. This was not a direct recommendation but rather because the report stated that there was not enough safeguarding and monitoring of doctors' decisions.