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Embrace the vertical future

Dr Peter Weaving says vertical integration of community services could mean GPs get to call the shots

The Health New Year is nearly upon us; it starts appropriately on April 1st. Where will you and the rest of the jobbing GPs be? Will you be absorbed into a polyclinic, or even a polysystem, federating with other practices and linking with community services as an integrated care organisation, an ICO? Or will you be able to admire the daffodils, swing into the surgery, kiss the PM and get on with the day job of minimising suffering and illness and maximising QoF?

The truth is likely to be in between. It is increasingly difficult to avoid the wind of change blowing through general practice and how it links with community services. Once again PCTs are being asked to distance themselves from their provider arms (the technical term for district nurses etc.) and, to my surprise, acute hospital trusts are lined up as the future host for our community services.

Mike Dixon, chair of the NHS Alliance, is worried the next step will be acute trusts taking over general practice. Ever the optimist I believe it will go the other way: as groups of practices work together under whatever badge, they and their commissioning clout will be in the driving seat steering secondary care. Hang on tight!

community services