In mid-February, the DHSC published a white paper entitled, ‘Integration and innovation: working together to improve health and social care for all’. The study lays out a roadmap for the future of healthcare, and reveals “legislative proposals for a Health and Care Bill” which it hopes will deliver “a system that’s better able to serve people in a fast-changing world”.
The reforms that are being proposed will remove barriers to integration, bureaucracy and create systems that are “more accountable and responsive to the people who work in it”.
If realised, the proposals, which will begin to come in to force next year, will transform patient health care as we know it. It is widely held, in theory at least, that creating Integrated Care Systems that seamlessly link health and social care sectors can produce better outcomes. But such a move will also herald a period of unprecedented change for those working in primary, secondary, and care sectors.
In this Q&A, Tracy Green, the Head of Primary Care for Quality Compliance Systems, sheds light on what the changes will mean for GPs.
She began by discussing why GPs should not fear change.
TG) “It is only natural that some sections of the England’s GP community are uncertain as to how the changes will impact their surgeries. Some are worried that ICS’s will take away their autonomy –particularly around managing budgets – which will become the sole responsibility of the ICS NHS body. Others have also expressed doubts as to whether their voice will be heard by the ICS Health and Care Partnership, whose job it is to plan and commission.
While I understand the reason for their anxieties, the organisation that I work for, QCS, a leading provider of content, guidance and standards, has been following developments closely.
While nobody can be certain of the future, there are many reasons to be confident that GPs will retain influence and autonomy. Collectively they see one million patients in a typical 24-hour period and since 1995 demand for their services has risen by a nearly a third. They are also pillars of their communities and perform an invaluable role. They really know their patients and their patients trust them. You only have to look at the vaccine take-up success amongst Cohort 6 (the 16-64 age group with underlying health conditions) to gauge their value.
It’s also worth stating that GPs are used to working collaboratively and dynamically with third parties. Many have been working in PCN frameworks for two years now. ICSs will simply enable them to think bigger, better and bolder in tandem with secondary care and social care providers. I think it is something, therefore, that most GPs will embrace.
While it will be impossible to really know whether GPs will have a seat at the commissioning table until the Health and Care Bill is published, Professor Martin Marshall, chair of the RCGP, remains hopeful that GPs will be at the heart of the process. He was recently quoted in a published paper saying that “there is a suggestion that there should be a strong general practice voice at the top of integrated care organisations”.[i]
Q) What are the potential benefits of working within Integrated Care Systems for GPs?
TG) “Firstly, I think that relieving GPs of sole responsibility for budgeting might not be bad thing – as long as they continue to have a say as to where funding is allocated of course. As a former Practice Manager, I know how much time GP surgeries have to spend on budgeting and finance. They’ll still have to do that of course because they will remain independent contractors. However, it is fair to say that not having sole responsibility of an overall budget will free up more time for GPs to see their patients.
Away from budgeting, I think ICSs offer GP’s a once in a generation opportunity to fix age-old problems that Covid-19 has ruthlessly exposed, such as reforming hospital discharge procedures, and working on ways to prevent unnecessary hospital admissions.
In the long term, unprecedented opportunities to compare, contrast and pool data in line with GDPR regulations are also likely to emerge. This rich seam of data could be transformative as it will reveal an accurate and real-time picture of the complex and often nuanced health challenges that local communities face. Equipped with this data, primary, secondary and social care services can work as one to provide a tailored package of health and social care to everybody who lives within the boundaries of the ICS.”
Q) We have talked a lot about the collaborative benefits that ICSs bring in this interview. What role can data-centric ICSs play in improving health both locally and nationally?
TG) “The collaborative nature of ICSs could pave the way for information sharing on a local, regional and national basis. If data reveals that there is a mental health crisis in one region, or an increase in cancer or dementia in another, ICSs could share best practice learning, policies and procedures that they have put in place to tackle the problem. If a culture of data sharing ensues, then this could be the first step to eradicating health inequalities, which Covid-19 has so cruelly laid bare.
Finally, while I think that Integrated Care Systems should not be considered a silver bullet, they have a vital role to play in helping to bridge health inequalities. How? Well, take Devon, my home county, for example. It often struggles to attract GPs, a point not lost on former Health Secretary, Jeremy Hunt four years ago. To entice trainee GPs to Devon, Cornwall, and other parts of the country that traditionally struggle to recruit GPs, he announced a £20,000 relocation package.[ii] Whether the policy was successful or not is impossible to say, but in my experience, GPs – particularly trainees – are not motivated by money. Instead they’re driven by making a palpable difference to the lives of the people they treat. Integrated Care Systems offer them the best opportunity to do so.”
Quality Compliance Systems
Quality Compliance Systems (QCS) supports over 100,000 customers in the health and social care sectors. Founded in 2009, QCS’s vision has always been clear from the start; ‘Helping to create a fairer and more compassionate world’. This vision comes to life through the digital delivery of all necessary compliance policies, procedures, guidance and inspections tools that GP practices require.
In partnership with industry leaders, QCS has been able to take another huge leap forward with a pioneering vision around content. By adding to its team of industry experts, whose views and opinions regularly appear in leading healthcare publications, QCS has expanded its area of expertise and is now seen as a leader in best practice – as well as compliance.
To find out more about QCS, contact our compliance advisors on 0333 405 33 33 or email firstname.lastname@example.org.