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BMA backs proposal to mandate more GP roles on ICS boards


BMA backs health bill proposal to mandate more GP roles on ICS boards


The BMA has backed a proposed amendment to the Health and Care Bill that would see more GP roles mandated on ICS boards.

It has also called for ‘formalised roles’ for LMCs ‘at every level of ICSs’.

It comes as the Bill yesterday moved from its second reading into the committee stage at the House of Lords, during which amendments will be debated and voted on.

In a Parliamentary briefing for peers, published last week, the BMA said it is ‘calling for amendments to the Bill that would strengthen minimum membership of Integrated Care Boards (ICBs) to include more than one GP and a clinical representative from secondary care.’

It said this comes as the Bill ‘as written risks undercutting local clinical engagement and leadership’ by losing ‘positive elements’ of CCGs, such as their ‘accountability to clinicians and patients as a body of elected local GPs’.

The document added that the BMA supports an amendment that would ‘ensure that primary care professions have mandated roles within Integrated Care Partnerships with a member appointed by each of the practitioner committees’, including LMCs.

It also supports amendments that would require the ICB, partner trusts and NHS Foundation Trusts to ‘consult the relevant primary care Local Representative Committees’ – such as LMCs – when publishing their annual ‘forward plan’, it said.

The briefing document added: ‘The BMA calls on peers to amend the Bill to ensure independent clinical leadership from across primary, secondary and public health care is embedded at every level of ICSs, including formalised roles for Local Medical Committees (LMCs) and Local Negotiating Committees (LNCs).’

It said: ‘The Bill sets out core minimum membership of Integrated Care Boards (ICBs), which includes at least one member nominated by GPs and primary care, a member nominated by NHS or Foundation Trusts, and a member nominated by local authority representatives. 

‘The BMA is concerned that this provision, and further detail set out in the NHSE ICS design framework, falls far short of ensuring clinical leadership and representation needed. ICSs are currently finalising their draft constitutions, including the proposed membership of their ICBs, with many failing to provide adequate representation for clinicians. ‘

It added: ‘The BMA is concerned the Bill risks undercutting truly representative clinical leadership by failing to retain some of the positive elements of Clinical Commissioning Groups. 

‘This includes their vital function in ensuring accountability to clinicians and patients as a body of elected, local GPs.’

Integrated care boards are due to be discussed tomorrow, according to a provisional schedule published today.

In June, NHS England guidance revealed that just one GP would be required to be appointed to ICS boards, which are set to replace CCGs as commissioners of health services.

GPs had previously warned that more must be done to prevent ‘tokenistic’ GP representation on ICSs, amid ongoing concerns.

The BMA council passed a resolution calling for MPs to reject the new Health and Care Bill in July, arguing it is ‘not the right time’ to be bringing in widespread legal reforms while the NHS deals with the Covid-19 pandemic.

Proposed amendments to the Health and Care Bill

Clause 21, proposed by Lord Hunt of Kings Heath, Lord Crisp and Lord Scriven:

This amendment would ensure that primary care professions would have mandated roles within Integrated Care Partnerships with a member appointed by each of the practitioner committees.

Clause 20, proposed by Lord Crisp, Lord Hunt of Kings Heath, Lord Scriven and Baroness Bennett of Manor Castle:

This amendment would require Integrated Care Boards to work with the four primary care services listed in schedule 3 (Primary Medical Services, Primary Dental Services, Primary Ophthalmic Services and Pharmaceutical Services) when preparing and revising their five year plans, in the same way they are required to work with NHS trusts and NHS foundation trusts.

Clause 20, proposed by Lord Hunt of Kings Heath, Baroness Thornton, Lord Scriven:

This amendment would ensure that in preparing their annual strategic forward plan, the Integrated Care Board and its partner NHS trusts and NHS foundation trusts would need to consult the relevant primary care Local Representative Committees and publish an explanation of how they took account of those views when publishing their plan.

Source: UK Parliament