GPs could merge with hospital services, says NHS chief executive

General practice could be merged into joint provider organisations with hospitals, NHS England's chief executive has said.

Simon Stevens: primary care could merge with hospitals
Simon Stevens: primary care could merge with hospitals

Addressing the NHS Confederation conference in Liverpool, Simon Stevens said new local models for care delivery could see GPs, hospitals and social services form new joint provider groups.

He said: 'What if in a few parts of the country - rather than perpetuate the increasingly arbitrary boundary between GP and community-based care on the one hand, and hospital-based outpatient, diagnostic and even some inpatient care on the other – these health professionals and perhaps even social services wanted to form new multispecialty provider groups?

'Perhaps taking delegated multi-year budgets to manage defined populations, while committing to use the dividend from more efficient team working to put the local NHS on a sustainable financial trajectory. What if some of these groups decided to team up with their local community or acute hospital?'

Mr Stevens said the NHS faced a ‘defining moment’.

‘I know there are enormous pressures, but the NHS is up for change, and necessity truly is the mother of invention,' he said.

But he told health professionals there would be no centralised top-down blueprint for reorganisation. We need different solutions for diverse communities. Horses for courses, not one size fits all.’

‘In some places mergers and reconfigurations will of course be needed. But in other cases the changing needs of our patients - often frail, some with dementia, many with multiple other health problems - coupled with the opportunities of new technology may mean we can better support people at home and locally. 

‘It's the energy and commitment of NHS staff, of our patients and our partners that can generate the answers.’

Mr Stevens also called for ‘unleashing more health and care bangs for the buck’ by increasing the proportion of NHS payments which will be explicitly tied to prevention, quality of care, and patients' own views. 

As part of that he announced a ‘hardnosed’ value for money review of incentives including QOF,  CQUIN and CCGs’ quality premium.

Finally he called for the NHS to ‘be at the forefront of the coming revolution in personalised medicine, the use of data to drive transparency and proactive care, and the full engagement of patients in their own care’.

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