Sackwell & Binthorpe: taking steps to cut red tape and gun crime

Penny here again, with your regular update from the primary care support team at the Sackwell & Binthorpe ICS.

Recently we sent out a short questionnaire inviting you to set our communication priorities for this issue. Many of you said you would like to know more about the ICS, how it will work and what it will all mean for primary care.

You said, we did: no more guidance documents

Throughout the summer, NHS England and NHS Improvement has been working to produce guidance on the new structures and their governance arrangements. 

To address complaints about the volume of guidance documents people are expected to read, NHS England colleagues have taken steps to reduce information ‘overload’, starting with a radical overhaul of key terminology. For instance, they no longer refer to ‘documents’ but to ‘product publications’ or simply ‘products’.

Over time, all NHS organisations and other partners in ICS will be expected to use the ‘product’ designation for any printed or electronic text presented in aggregated form, resulting in a steady reduction in the number of ‘documents’, as this term is phased out over the next 18 months.

During the transition period, primary care organisations are asked to start socialising the new term and preparing staff and patients for full adoption in April 2023. Note that ‘materials’ will continue to be an acceptable term for published content until further notice. 

The first phases of the summer product release clarified the roles of provider collaboratives, place-based partnerships, integrated care boards, and integrated care partnerships. It also covered the ICS people function, the ICB draft model constitution, establishment guidance, the readiness to operate statement and the ‘what good looks like’ framework for digital and data.

Remember, this is interim guidance, so you’ll have the opportunity to read it all again when it is reissued with minor changes in the autumn.

And that’s just the start!

Early September’s products will include guidance on ‘thriving places’, which will be equally applicable to places already thriving, those with interim thriving arrangements and those that are yet to thrive as a result of being placed in special measures. A self-assessment tool to measure thriving maturity is expected soon, along with a scorecard to enable ranking of areas in a national Flourishing Places Index.

Also in September, expect to see guidance on working with people and communities, which should be particularly useful for organisations working with people for the first time as well as those who could do with a refresher.

For more information see our handy explainer People – Everything You Need to Know and the latest product from our comms and engagement team Communities: What Happens When People Live Together in the Same Place. We’ve also published a step-by-step how-to guide to working together with sections on how to find people, when to hold meaningful conversations, how to support them to make the changes they want to see, and what to do if they don’t want to work with you.

So where is primary care in all this? In the hundreds of pages of guidance, there are as many as several references to the vital role of primary care, which is expected to be central to the ICS ‘in due course’. For example, at least one seat on the integrated care board (ICB) is to be filled by a GP.

Every ICS area is expected to nominate the GP who can demonstrate that they represent all the area’s primary care organisations and staff. In the absence of a suitably qualified candidate, the ICB will appoint the individual with the most plausible leadership credentials, eg) most followers on Twitter or articles published in the BMJ.

Mental health and firearms licences

You may have read that the home secretary Priti Patel expects GPs to carry out medical checks in support of firearms licences. The scheme will build on the success of the Prevent programme under which GPs are expected to refer to the authorities any patient they believe may be in danger of being radicalised and drawn into terrorism. A new QOF indicator will incentivise GPs for identifying potential armed killers. 

We hear your concerns that preventing gun crime may add yet another task to your already busy day, but we all have a role to play. GPs will simply be asked “to have due regard to the need to prevent people from shooting other members of their community”.

GPs are of course uniquely qualified to determine whether a patient is likely to go on the rampage with a pump-action shotgun. Try to leave time during your consultation to start a non-judgemental conversation about firearms and the individual’s attitude to extreme violence.

In coming months, we expect to see draft guidance which is likely to draw on the existing anti-terrorism framework.

Meanwhile, the ICS will soon issue its own helpful interim explainer to practices. It includes a list of the tell-tale signs such as: Is the patient wearing an ammunition belt? Do they have a history of gun crime? Is their automatic weapon a cry for help? Have they ever drawn a gun on a member of the practice team?

If you have other top tips to share, let my team know and we’ll include them in the guide.

Penny Stint is primary care enablement lead for the Primary Care Support and Strategic Integration Unit (PCSSIU) at the Sackwell & Binthorpe ICS. As told to Julian Patterson