ICBs urged to consider decommissioning services from GP practices

ICBs have been urged to take a ‘bold’ approach to planning services, including decommissioning services from GP practices and looking ‘beyond traditional healthcare providers’. 

These considerations will form part of five-year planning strategies every ICB must produce by January next year and update annually, according to a new NHS England strategic commissioning framework. 

ICBs will also continue to be responsible for the performance of primary care providers, the framework document stated. 

Earlier this year, an NHS England draft ‘model ICB blueprint’ outlined areas which could be transferred to new ‘neighbourhood teams’ in order to help ICBs achieve a 50% reduction in running costs.

NHS England defines ‘strategic’ commissioning as planning for services ‘over the longer term’ to ‘improve population health, reduce health inequalities and improve equitable access to consistently high-quality healthcare’.

The framework said: ‘ICBs, to varying degrees of success, have been carrying out the four stages of strategic commissioning but now is the time for a more comprehensive and consistent approach across all ICBs.  

‘This requires commissioners to be bold and rearrange and, potentially, decommission services to secure the best possible health outcomes, quality of services and value for the taxpayer, while ensuring they continue to reduce healthcare inequalities.’ 

ICBs will ‘continue to be accountable’ for the performance of primary care providers and national contract requirements such as for primary care, the framework said, while ‘regional NHS teams’ will take a lead on overall provider trust performance from April next year.

The document also suggested strategic commissioners should ‘look beyond traditional healthcare providers’ by considering ‘community assets’ as part of neighbourhood health service planning.  

It added: ‘As part of a forthcoming strategic commissioning development programme, NHS England will support ICB commissioners of GP services to create the right conditions for improving general practice, including with nationally delivered tools and programmes that can enable ICBs to develop their capabilities.’

Elsewhere in the framework, NHS England reiterated the central role of the NHS federated data platform (FDP) in aiding commissioning decisions.  

The FDP, intended to link data from across NHS organisations to support both planning and direct care, began rolling out in NHS trusts last year. 

Palantir – a US tech firm known for its work with US intelligence and security agencies – was awarded a £330m, seven-year contract in 2023 to deliver the FDP. 

‘ICBs should use the capabilities that will be provided through the NHS FDP to support segmentation, risk stratification and predictive modelling and work with the NHS FDP team to develop this offer further,’ the framework said. 

Integrating data with the FDP need to be preceded by establishing ‘necessary data sharing agreements across partners’ as well as ‘information governance to allow for re-identification of at-risk cohorts within clinical settings’. 

NHS England said a model ‘digital blueprint’, which will be published in 2026/27, will guide ICBs on connecting to the FDP, as well as the NHS app and from 2028 the single patient record. 

Last month, NHS England announced an aim to set GPs a new target of seeing 90% of all ‘clinically urgent’ patients on the same day. A medium-term planning document published sets as one of its targets to ‘improve access to primary care, including reducing unwarranted variation in access’.

Pulse has investigated how local enhanced service funding varies widely across different commissioning areas in England.