GPs could control hospital admissions and nursing in radical primary care overhaul

NHS England has set out requirements for practices applying for funding to set up new integrated care models.

Hospital: GPs could control admissions (Photo Science Photo Library)
Hospital: GPs could control admissions (Photo Science Photo Library)

Guidance issued this week for applicants to the £200m transformation fund for new care models, suggested GP-led integrated organisations could be expected to provide services such as district nursing and health visiting, pharmacy, dentistry, step-down beds, re-ablement and domiciliary care.

Multispecialty community providers (MCP), one of several models outlined in NHS England’s Five Year Forward View, will provide integrated out-of-hospital care combining primary and community services.

The integrated bodies, which will be formed around groups of GP practices, will serve a minimum population size of 30,000-50,000 registered patients but could be even larger, the guidance said.

Expanded community teams

MCPs could also run expanded multi-disciplinary community teams, including pharmacists, and social workers, and could even take control of parts of district general hospitals, with GPs given admitting rights.

The bodies will manage a new type of capitated contract for population health and care covering the range of services it directly provides.

Practices have until 9 February to register an interest in becoming ‘vanguard sites’ which will be used to replicate the model elsewhere.

Vertical integration of NHS services

The guidance also sets out details for applicants to form primary and acute care system models (PACs) which will vertically integrate hospital, mental health, primary and community services and potentially social care, and could include measures to expand new GP services in under-doctored areas.

These integrated organisations could, the guidance said, redesign pathways and workforce roles, such as blending ‘the role of a general physician with that of a general practitioner’.

PACs would take control of a single, capitated budget for its registered population from NHS England and CCGs and potentially from local councils.

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