Commons committee report reflects BMA’s concerns on integrated care

By Agencies
June 12, 2018

The House of Commons Select Committee on Health and Social Care has published a report, Integrated care: organisations, partnerships and systems. The Committee recognises the potential benefits of further integration and calls on the Government to bring forward legislation to remove legal barriers imposed by the Health and Social Care Act 2012. Many of the necessary changes require primary legislation.

To rebuild the trust that previous and repeated top-down reorganisations have eroded, the Committee recommends representatives from the health and care community – the NHS, local government, professional bodies, patient groups and the voluntary sector – lead on the development of new legislative proposals for the Government to lay before the House in draft and present to the Health and Social Care Committee for pre-legislative scrutiny. 

Rather than threatening the integrity of the NHS, says the Committee, reforms to better join-up the organisation of services, including health and social care, present an opportunity to row back the NHS-internal market. However, the litmus test must be whether these changes improve the care, outcomes, and experience of patients. 

Responding to the report, Dr Chaand Nagpaul, BMA council chair, said: “At a time when the NHS is buckling under the combined pressures of soaring demand, insufficient capacity and underinvestment, the BMA agrees in principle with a more joined-up approach, including greater collaboration within the health service, and between health and social care.

“However, it is clear that the way in which transformation plans are being rolled out lacks transparency and has made minimal genuine efforts to engage healthcare staff, patients and the public. From STPs to ACOs and now ICSs and ICPs, professionals and the wider population alike are left to navigate a maze of meaningless acronyms with little explanation.

“This report reflects a number of our concerns, including the lack of consultation and engagement surrounding such plans and the need for patient care to be put at the heart of any moves towards an integrated care system.  

“As we addressed in evidence to the recent judicial review on Accountable Care Organisations (ACOs) the BMA is concerned that such transformation plans will operate within current procurement rules, which risks handing an area’s NHS budget to private providers through competitive tendering. Added to this is the insecurity of fixed-term ACO contracts which will require re-bidding every 10 years and which a provider can terminate and walk away from early. We are pleased that the Committee agrees with the BMA’s call for legislative change to remove legal barriers imposed by the Health and Social Care Act 2012. The BMA has long been calling for the current damaging and wasteful competition regulations enshrined in the Act to be removed.

“The Prime Minister has outlined her intentions to draw up a long-term funding plan for the NHS, and this is an opportunity to ensure that resources better match expectations around achieving a more integrated service. 

“The BMA recently launched its Caring, Supportive, Collaborative project through which we will be setting our vision for an NHS free from competition,  and we urge the government to work with us to guarantee the future sustainability and prosperity of our health service.”

* Read the report Integrated care: organisations, partnerships and systems here 

* Health and Social Care Committee https://www.parliament.uk/business/committees/committees-a-z/commons-select/health-and-social-care-committee/

* British Medical Association https://www.bma.org.uk/

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