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NHS chief calls for GPs to work within community hospitals

GP networks could provide care from small, local hospitals through funding from a joint primary and secondary care budget, the chief executive of NHS England has said today.

Speaking to the NHS Confederation conference in Liverpool, Simon Stevens said there ‘is now real momentum building in favour of testing some new models of general practice and extended primary care’ and that this could include groups of GPs and community-based care providers ‘teaming up’ with their local community or acute hospitals funded by ‘delegated multiyear budgets’.

Mr Stevens put forward a series of ‘potential new variants’ to the current models of healthcare, but emphasised that NHS England would not force GPs to work in any such models.

He told delegates: ‘[W]hat 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 multiyear 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? […] Or what if some of these smaller hospitals, realising the benefits of shared back offices, informatics, and wanting to spread know-how about efficient care processes, chose to form non-contiguous networks with other like-minded institutions across the country?’He added that no model should be ‘imposed’ on the NHS.

He said: ‘Each of these ideas – and several others like them – offers some promise. But none of these ideas should be imposed on the NHS, as a national blueprint or reorganisation. Instead, what I want to see – and I’m confident this is a shared view with Monitor and Trust Development Authority – is an NHS that is more flexible, more adaptable, where national and local thinking converges to create different clinically and financially sustainable paths for particular communities.’

It comes as last month, Mr Stevens invited CCGs – which hold the local secondary care budgets – to bid to co-commission primary care with NHS England.

Mr Stevens also indicated that he would be taking reviewing incentive schemes for GPs. He said: ‘We’re going to get smart about commissioning and take a better look at incentives. And NHS England is currently expecting to spend about £2.7bn per year on various performance incentives for community and acute providers, GMS GPs and CCGs. I tell you now we’re going to take a very hard-nosed look at what we’re getting for that money, and whether we can do better.’