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GMS Contract “should incentivise integration”

Health secretary agrees GMS Contract should incentivise integration

Louise Prime

Wednesday, 11 January 2012

The Government wants GMS Contract negotiations to include incentives for providing integrated care, health secretary Andrew Lansley has revealed, to the fury of many GPs.

Integration should be at the heart of healthcare, the NHS Future Forum insisted in its latest report. Mr Lansley agreed, in his written response to Forum chair Professor Steve Field, that the Government would “incentivise collaboration” and “hold organisations to account for providing integrated services … through the NHS Outcomes Framework”.

Controversially, he went on to say that he welcomed the Forum’s recommendation that the NHS Commissioning Board “should promote integrative approaches to out-of-hospital care and … explore how to incentivise integrated care in General Medical Services contract negotiations”.

Some GPs have reacted furiously, arguing that although GPs do want integrated care, they have actually been prevented from achieving it by the way in which the health and social care services are organised.

GPC deputy chairman Dr Richard Vautrey told GP that encouraging integration through the contract is the “wrong way to go about it” and argued that integration between practices is already commonplace. He said: “There isn’t a need for contractual change. It would also bring into question the independence of individual practices, which is what patients value.”

The Forum said in its report, which the Government has fully accepted:

  • Integration should be defined around the patient, not the system – outcomes, incentives and system rules (i.e. competition and choice) need to be aligned accordingly.
  • Health and wellbeing boards should drive local integration – through a whole-population, strategic approach that addresses local priorities.
  • Local commissioners and providers should be given freedom and flexibility to ‘get on and do’ – through flexing payment flows and enabling planning over a longer term.

RCGP chair Dr Clare Gerada said the College was pleased that the Forum’s report “acknowledges the crucial role of GPs in the planning and delivery of joined-up services for patients”. She said: “GPs are the key to delivering integrated services – locally led and built around the patient – in the community and in the traditional hospital setting.”

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