The government is set to press on with controversial and wide-ranging reforms of primary care, it has been reported.
The proposals, expected to be published later this month, would see the abolition of clinical commissioning groups and their replacement by Integrated Care Systems, covering wide geographical areas. The new systems will have a role similar to the health authorities that existed 40 years ago, providing and funding a range of services.
Proponents of the change say they can “break down” harmful barriers such as those between the NHS and council-run social services. Critics say they will strip power from practices.
NHS Confederation chief executive Danny Mortimer said: “This is the future of health and care. The current legal framework has held us back and new legislation is needed, building on how NHS organisations have worked effectively together, especially during the pandemic. There is often anxiety about ‘another NHS reorganisation’, but the NHS and the partners we work with across other public services have been on this journey now for several years. This is the logical next step.
“However, there will be important detail to work through. Ensuring these changes fully involve our partners in local government will be high up the list, as will getting accountability to the Government right given the NHS is a public service that costs over £100bn a year to run. The Government and regulators will need to strike the right balance. There is concern though that in an overly centralised system, regardless of the arrangements at a national level, the reforms need to better empower local NHS and care leaders to lead – they are best placed to run health and care services for their local communities.”
The CCG in Leeds, meanwhile, has accused NHS England of a “significant lack of insight” in proposing CCG abolition, the Health Service Journal reported. It warned of “significant disruption”, accusing NHS England of devaluing the work of CCGs.
Its chief executive Tim Ryley told the journal: “The CCG remains concerned that more advanced systems such as West Yorkshire and Leeds would be disrupted without more careful consideration given to ensuring the risks of the proposals were recognised and mitigated.”
The journal also reports problems at a new ICS in Surrey, chaired by the leader of Surrey County Council. A review of the ICS, known as Surrey Heartlands, found its governance was “repetitive, overly complex and burdensome.”
The journal goes onto report that NHS England draft proposals state that an ICS should have two leadership boards. One would be an NHS board, to oversee NHS services, and a second would be a “health and care partnership.” The partnership would be responsible for developing long-term plans to tackle the “wider” needs of the system.