GP commissioners will need 'significant support' to integrate services

GP commissioners will need 'significant support' if they are to make services more efficient and integrated, policy experts have warned.

Professor Chris Ham: one of the strongest messages from the report is that commissioning integrated care is ‘not easy’.
Professor Chris Ham: one of the strongest messages from the report is that commissioning integrated care is ‘not easy’.

A joint report by the Nuffield Trust and the King’s Fund said PCTs have struggled to integrate services as they have found it difficult to ‘stretch the boundaries’ within current NHS policy.

The authors warned that clinical commissioning groups (CCGs) will find it equally difficult unless they receive greater support from policy makers.

Commissioning integrated care in a liberated NHS suggests the government should re-look at payment mechanisms within the NHS, as the Payment by Results policy has not supported integration.

It says it could look at the possibility of episode-based payments where payments for a range of services relating to an episode of treatment are bundled together.

It also says capitation payments that cover all the costs of care for a defined population over a certain time period could be used, or work could be accelerated on personal health budgets to enable patients to commission care packages themselves.

The report also said the government must encourage the commissioning of integrated care by making sure the NHS Commissioning Board (NCB) provides guidance and support to help CCGs with the agenda.

Professor Chris Ham, report co-author chief executive at the King’s Fund, said one of the strongest messages from the report is that commissioning integrated care is ‘not easy’.

He said: ‘As CCGs prepare to take on responsibility for commissioning three lessons stand out. First, groups will need support from the NCB.

‘Second, the government must ensure that Monitor and the NCB support both competition and integration. Third, work is urgently needed on how to create the right incentives to support integrated care.’

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