General practice must be 'foundation of any successful ICS', warns RCGP

General practice must be the 'foundation of any successful integrated care system (ICS)', the RCGP chair has warned amid concerns over the impact of NHS reforms.

RCGP chair Professor Martin Marshall (Photo: Pete Hill)
RCGP chair Professor Martin Marshall (Photo: Pete Hill)

The warning comes after NHS chief executive Sir Simon Stevens told MPs on 9 March that reform plans in a recent government white paper would see ‘not just GPs on CCG governing bodies’ making decisions - and that funding streams could be pooled.

The white paper - published last month - outlined plans to bring the NHS and local government together legally in integrated care systems (ICSs) - scrapping CCGs.

Responding to Sir Simon's comments, RCGP chair Professor Martin Marshall has said that strong GP involvement in ICSs is key to GPs and practice teams delivering high quality care to patients.

Health care reform

GPonline understands that the college is in discussions with the government to ensure that GPs will be involved in shaping the aims of ICSs, and that PCNs are strengthened by any reforms to health and social care.

In a House of Commons health select committee evidence session on the white paper, Sir Simon said: ‘[The proposals] would bring together a wider group of stakeholders to make planning judgments - not just groups of GPs on CCG governing bodies - but also other providers, patient groups and local authorities.’

The white paper makes clear that ICS health and care partnerships, which will include stakeholders from across health, social care and local government, will be used as a forum for ‘agreeing co-ordinated action and alignment of funding on key issues’.

However, the plans do not stipulate how these groups should be arranged, or how many GPs would need to sit on the panel. Sir Simon said the NHS did not want to be prescriptive about the makeup of these groups, but did reveal that guidance would be issued.

General practice representation

Dr Marshall told GPonline: ‘The college is broadly supportive of the integrating care agenda outlined in the government’s white paper. However, as ever, the devil is in the detail and it’s important that there’s a strong primary care presence within integrated care systems - general practice must be the foundation of any successful ICS. That’s the only way to ensure that GPs, our teams and the wider NHS are best enabled to deliver care to our patients.

‘There’s no doubt that the success of such systems won’t simply depend on legislative changes, but rather on good relationships across the NHS and a long-term investment into the NHS workforce so that we can deliver these systems.’

He continued: ‘The college is keen to remain in discussions with the government to ensure that GPs and our teams are shaping the aims of ICSs, and that PCNs are strengthened by ICSs ensuring GPs have a strong leadership role and a voice in localities - this will ensure that patients remain at the heart of NHS.’

Professor Marshall argued at the annual RCGP conference last month that GPs needed a 'strong voice' within ICS as they take over CCG budgets and commissioning powers. BMA GP committee chair Dr Richard Vautrey has also called for 'fair representation’ for NHS providers impacted by decisions made under the reformed model.

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