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New care model plan contains ‘no detail’ on GP involvement, grassroots warn

GPs in Leicestershire have criticised a local plan to form an accountable care system (ACS) because the plans are unclear on how GPs will be involved.

According to a board paper from NHS Leicester City CCG, the plan will see the local healthcare system take on the budget responsibility to design and deliver services ‘to best meet the needs of its population’.

It adds that ‘over time’ partners in the ACS, including local hospital trusts, NHS East Leicestershire and Rutland, NHS Leicester City and NHS West Leicestershire CCGs, will begin ‘ceding some individual sovereignty for the current responsibilities they have’ in Leicestershire to work on this ‘joint endeavour’. 

However, Dr Anu Rao, medical secretary of Leicester, Leicestershire and Rutland LMC said: ‘As always, the devil’s in the details and the LMC strongly felt that there wasn’t much detail about how and what the proposal of the accountable care systems is.’ 

She said: ‘What exactly does it mean for primary care? How are you going to integrate practices into the accountable care system? How is it going to improve patient access with issues around workload and workforce for general practice?’

The discussion paper says GPs will be involved in ‘local horizontally integrated multi-disciplinary community provision’.

It adds that this will involve building ‘on GP federations, primary care home and neighbourhood hub and spoke models already being supported in each CCG area working with their member practices’.

According to the paper, the move to create an ACS is in ‘the national context’ of the development of sustainability and transformation partnerships into ACSs.

NHS England has previously criticised Leicester’s regional plan to overhaul health and social care, drawn up by the sustainability and transformation partnership, for failing to support general practice.

Dr Rao said: ‘The paper just talks about a new organisational form, the new structure, but it doesn’t give detail around how they are going to resource all that. 

‘It seems like another organisational reform rather than actually how is it going to address the issues around GP opening hours or workforce.

She added: ‘The concern is already GPs are under a lot of workload pressure and there’s a big workforce crisis, so whatever systems they develop have to address that is a major area that we will be pressing on for the accountable care system in the future.’

She said the LMC has asked the CCG for more ‘tangible outcomes and answers to our queries’. 

According to the board paper, partners in the accountable care system will be asked to approve a memorandum of understanding to set up the system in December.