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PCNs to receive monthly data from CCGs on cost of A&E admissions in their region

CCGs will be expected to provide monthly data to primary care networks (PCNs) on the cost and number of A&E attendances in their network’s region, NHS England has revealed.

In operational and planning guidance published at the end of last month, NHS England said the A&E data should form ‘an integral part of the PCN dashboard’.

The guidance, which will come into force in 2020/21, also states local planning bodies – including sustainability and transformation partnerships (STPs), integrated care systems (ICSs) and CCGs – will be required to work with networks in ‘supporting improvements in practices with long waits for routine appointments’.

When the five-year GP contract was announced last year, NHS England said it would develop a new ‘network dashboard’ from April 2020 to measure progress on key metrics such as hospital use and urgent and anticipatory care. 

In its latest document NHS England reiterated it expects ‘all providers’ to have measures in place by 2020/21 to improve A&E performance.  

It said: ‘In 2020/21 A&E performance must improve, and all providers should plan to deliver a material improvement against a 2019/20 benchmark.

‘To achieve this, systems and organisations will be expected to reduce general and acute bed occupancy levels to a maximum of 92%.

‘This means that the long period of reducing the number of beds across the NHS should not be expected to continue. In addition, local systems should deliver improvements to the responsiveness of community health service via the two-hour crisis response.’

When laying out the specifics of what STPs/ICSs and CCGs must do, it said: [They] must work with PCNs to a particular early focus on supporting improvements in practices with long waits for routine appointments.

‘CCGs must provide monthly data to each PCN showing the number and cost of A&E attendances by that PCN’s patient population. During the year this should form an integral part of the PCN dashboard.’

Lancashire and Cumbria LMCs chief executive Peter Higgins argued this will place another burden on PCNs. 

He said: ‘I wish the NHS would start looking at what is meaningful and useful for primary care. Of course PCNs need to have a focus on the workings of the total health care system, but at this stage, with population health management in its infancy, it is too soon to measure PCN success on A&E attendance figures.

‘There are many factors that influence people attending A&E and these are not all related to the actions of GP practices or PCNs.

‘This is yet another burden on PCNs and I would be asking what the local health systems are doing to support general practice and influence people about where to go for treatment. This is not a quick fix.’

NHS Clinical Commissioners (NHSCC) said NHS England’s new guidance was ‘prescriptive’ for CCGs.

NHSCC chief executive Julie Wood said: ‘We recognise that in response to what has been, by comparison, a generous settlement for the NHS, there is a lot expected of organisations and lots of priorities to deliver on, on top of a very stretched service where patient need and demand continues to be challenging.’

She added: ‘The guidance in places is quite prescriptive about the expectations of organisations at a time when we are asking those same organisations to be less focussed on themselves and more focussed on working in a collaborative and integrated way across systems, so this will need to be managed carefully.

‘CCGs are likely to have a number of potentially competing priorities that they must invest their money in, and that money cannot be spent twice.’