NHS reforms vital for improving care but current proposals could lead to the loss of clinical leaders’ expertise

Commenting in response to the Government’s NHS White Paper that has been published today, including plans to create statutory integrated care systems, Lou Patten, CEO of NHS Clinical Commissioners and NHS Confederation ICS Lead, said:

“It is the logical next step to establish integrated care systems as statutory bodies and build on the progress that has been made in recent years bringing together service provision, strategic commissioning and clinical leaders, all of whom will have an obligation to collaborate to improve the health of the communities they serve.

“These reforms will take this further and ensure there is stronger integration within the NHS and between the NHS and local government. This will support place-based joint working to help address the wider determinants of health, support people to live healthier lives and to improve value to the taxpayer. It’s pleasing to see that the reforms will ensure the new statutory bodies are about much more than the NHS.

“Clinical commissioners agree that moving to a more integrated model is the right direction for the NHS; we can see that many of our member recommendations are in the Government’s paper. However, the current proposals could lead to the loss of huge amounts of senior staff experience and the expertise of our current clinical leaders, at a time when current CCG expertise must be retained to establish the bedrock of ICS commissioning. This must be addressed or we risk a lot of upheaval for little gain.

“There is a lot more detail to work through in the months to come before we see the draft legislation, not least in terms of how the Government intends to ensure there is local flexibility for integrated care systems to determine their own governance arrangements while ensuring we avoid any confusion in accountability. Given there will be a statutory NHS board for integrated care systems, working alongside a wider Health and Care Partnership Board involving local government, we’ll need to ensure there is clarity between the roles and responsibilities of both boards.”

NHS Confederation Chief Executive Danny Mortimer added:

“These are the most important set of reforms the NHS has had in a decade. The reality is that the 2012 reforms have largely failed and changes are needed. The reforms will help unlock some of the barriers front-line services face when trying to join up care for the public. The future of health and care must now be based on collaboration and partnership working – these reforms will provide the necessary updates to legislation to make this happen.

“The NHS traditionally fears disruptive reorganisations. But this time round there is much support for these reforms given they will boost efforts to integrate patient care. The use of competition and outsourcing as the main tools to improve quality of care and value for money for taxpayers will be replaced by collaboration and partnership working. This is what leaders across the NHS want. But that doesn’t mean we should end up with local monopolies as we must continue to work effectively, as we now do, with independent and voluntary sector providers.”

Read more comment from the NHS Confederation (of which NHSCC is part).

11 February 2021