Only hospitals with ‘good relationships’ to commission primary care, says NHSE

Hospital trusts looking to take on new commissioning responsibilities have been told they must demonstrate a good working relationship with primary care. 

Recently released criteria for trusts applying to become ‘advanced foundation trusts’ says they should account for ‘the likelihood of support’ from primary care and evidence of an ‘improved’ interface. 

Trusts performing well according to the NHS Oversight Framework can apply to become advanced foundation trusts. This gives them the opportunity to hold integrated health organisation (IHO) contracts, which hold the whole health budget for a ‘defined local population’.  

The guide for advanced foundation trust applicants says: ‘For potential IHO designations, regional teams will also consider whether the trust has the organisational capabilities and necessary leadership and relationships to take on responsibility for improving population health outcomes and driving the shift of care into the community.  

‘They should also consider the trust’s capability to manage financial risks and the likelihood of support from system partners across health and local government, including primary care, and ensure support from the ICB.’ 

Meanwhile, the assessment criteria asks that trusts are ‘actively engaged with system partners in managing actual or emerging quality concerns and working collaboratively with people who use services, carers and with the wider community to reduce risk and impact for patients.’ 

This includes showing ‘evidence of how the interface between primary and secondary care is being improved’ as an example. 

It comes as the BMA recently warned that the prospect of secondary care running general practice ‘remains likely’, while urging GPs to request meetings with local trusts and ICBs and to seek further details on neighbourhoods. 

And some ICBs have already chosen trusts – rather than GP practices – to lead their neighbourhood models.