Integrated care plans 'threaten key plank of GP contract reform'

Primary care networks could be undermined by plans to allow the government to set up new 'integrated care trusts' with control of NHS resources across parts of England, the GPC has warned.

GP funding (Photo: iStock.com/georgeclerk)
GP funding (Photo: iStock.com/georgeclerk)

An NHS England document setting out proposed legislation to pave the way for the NHS long-term plan says that 'the law should be clarified so that the secretary of state can set up new NHS trusts to deliver integrated care across a given area'.

It says this step is necessary because 'in some cases it may be difficult for commissioners to identify an existing organisation' capable of taking on an integrated care provider (ICP) contract. ICP contracts have been developed to 'enable the integration of services under a single contract', which could encompass primary and community care, social care, acute hospitals and other health and social care services.

GPonline reported last month on warnings from the BMA's GP committee that GPs must not face pressure to ditch their existing contracts, after the government changed legislation to allow practices to join these area-wide ICP deals.

GP contract

But just weeks after a new five-year GP contract agreement promised £1.8bn in funding to support the development of primary care networks - which all practices in England are expected to join by June - the GPC has warned that proposed legislation on ICPs threatens to undermine the influence of these networks.

GPC chair Dr Richard Vautrey: 'We have made our serious concern about the impact of ICPs known repeatedly and we continue to do so. These proposals would undermine the positive potential that working together within primary care networks, based on the existing GMS or PMS contact, could bring.

'There is no need for practices to give up their contract to be able to develop sensible collaboration with local NHS services and put in place improved community based services as a result. This should be the primary focus and we will be responding to this consultation to make that clear.'

Integrated care providers

ICP contracts are described as 'a discretionary and flexible tool for local commissioners'. Commissioners, who can 'decide in the light of local circumstances whether to bring services together using ICP contracts and if so which services should fall within the scope of the contract'.

The NHS England consultation says 'integrated care trusts would only be established where local commissioners wish to bring services together under a single contract, where there has been appropriate local engagement and where it is necessary to establish a new organisational vehicle for these purposes'.

It adds that 'the resulting integrated care provider would have a contractual duty to deliver and improve health and care for a defined population; act as a provider of integrated care with the freedom to organise resources (money, staff, and facilities) across a range of health and care services, working – as appropriate – in conjunction with other local partners; be run in a way that involves the local community and the full range of healthcare professionals, including GPs; and be accountable to commissioners for its performance'.

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