The Hewitt Review of integrated care systems was published on 4 April 2023.
Section 4 of the report sets out recommendations to build on the work and recommendations of the Fuller Stocktake, focusing on what needs to be done to create integrated neighbourhood teams. The Review also recommends changes to primary care contracting arrangements.
Key messages include:
- As ICBs take over responsibility for the commissioning of community pharmacy, optometry and dentistry, they should take the opportunity to ensure better integration across the full range of primary care services.
- ICBs should play a greater role in driving primary care transformation.
- National contracts “present a significant barrier to those within the GP partnership model who want to work in innovative and transformational ways” and “provide far too little flexibility” at ICS level to achieve the best outcomes for the local population.
- The quality and outcomes framework should be updated to refocus resources on prevention and measure outcomes rather than just activity.
The Review recommends that NHSE and the DHSC convene a national partnership group to develop a new framework for GP contracts to look at matters such as:
- The outcomes that we want from primary care, which should be developed closely with patients and the public and include patient reported outcomes and experience among the measures of success.
- The balance between national specifications and local flexibility.
- Joining up the different elements of primary care, including urgent care.
- National standards including clear expectations around digital and data.
- How to incentivise and support primary care at scale – this could include practices merging, federating, working within PCNs or GPs working as part of a multi-disciplinary primary care division within a wider NHS Trust.
- How to support struggling practices to improve.
It is clear that working at scale and integration remain firmly on the agenda. The Review calls for systems to have the flexibility to find the solutions that work best for their circumstances, including “building on the partnership model rather than sweeping it away entirely”.
PCNs have a unique opportunity in the final year of the network contract DES to build on their existing relationships and ensure that they have robust structures in place to enable primary care to operate effectively at place and system level.
If you’d like to discuss the future of PCNs, why not join our webinar on 27 April 2023 at 1pm? Find out more here.
For further information, please contact:
Alison Oliver, Partner, Hill Dickinson
alison.oliver@hilldickinson.com
