Divide between primary and secondary care is ‘absolute nonsense’, says NHSE chief

The divide between primary and secondary care is ‘absolute nonsense’ and NHS England is working on changing funding flows to ‘support neighbourhood care’, the commissioner’s chief executive officer has said.

In a keynote speech at the NHS Confed Expo in Manchester today, Sir Jim Mackey also said that NHS England will publish ‘patient experience standards’ before the end of the month, setting out among other things what patients should expect to happen after a referral is made.

He said: ‘Let’s stop all this primary, secondary care divide stuff. The population, they shouldn’t see it, they shouldn’t feel it, it shouldn’t be a thing anymore. It’s absolute nonsense.

‘They honestly should not have to worry about how we’re organised. They should just feel that it’s organised, it’s seamless. People are sharing information, they work together in teams.’

On publishing the patient experience standards, Sir Jim added: ‘The things that matter in elective care are often “I’ve seen a GP, I think they said I was being referred, I’m not sure, because nobody’s ever acknowledged it”.

‘You never get anything to say “we’ve got your referral, this is what’s going to happen next”. We’re going to try and release before the end of the month patient experience standards that start leaning into that and setting out a bit more clarity on this.’

NHS England has already stipulated patient rights when it comes to general practice in the patient charter – which stipulates the right of patients including on access and registration – which GP practices must display as per last year’s contract.

Sir Jim also said that for neighbourhood health to succeed funding flows will ‘absolutely’ have to change.

He said: ‘We’ve got some suggestions from the service about things they’d like us to do within our mechanisms to move money in different directions to support neighbourhood care.’

It comes after the Treasury launched a review focusing on how to shift funding from hospitals into primary and community care, including testing new financial flows.

The Government asked the National Institute for Health and Care Research (NIHR) to produce an ‘overall recommendation’ on replacing the Carr-Hill formula for GP funding, which could include a departure from the existing approach.

And an analysis conducted as part of the 10-year health plan recommended that the Government should consider different ways of funding general practice – including partial payment for a GP practice only being ‘released’ if ‘a certain proportion of patients confirmed they were satisfied with the waiting time before their appointment’.