The Health and Care Bill: The impact on primary care

Whilst the creation of Integrated Care Systems (ICS) seeks to address the “…need for integration and collaboration across the system” [para 38 Health and Care Bill Explanatory Notes] when it comes to the commissioning and provision of health and care services in England, both the role of primary care and impact on primary care providers remains rather opaque.

On the face of it nothing much will change on the practical level if the new Health and Care Bill (the Bill) is introduced.

Yes, commissioning functions will shift from CCGs to ICSs and the necessity for primary care providers to be a member of the CCG drops away but in reality

  • the types of contract available for use when it comes to commissioning primary care services (i.e. APMS, GMS and PMS contracts) remain the same,
  • the parties capable of entering into those contracts won’t change, and
  • (at least under this piece of proposed legislation) the services they provide won’t change.

Thinking more laterally this is hardly a surprise. With the introduction of the Network Contract DES, primary care providers are already very much on the path towards greater integration with the emergence and development of Primary Care Networks (PCNs) at neighbourhood level and the evolution of the service specification that links to the same.

This is not to say we won’t see changes. The Network Contract DES is an annual contract and as such changes it is highly likely that the DES specification for 2022/23 which will place greater obligations on PCNs when it comes to their involvement within their relevant ICS.

It will, therefore, be interesting to see what changes are proposed when the draft specification for next year’s Network Contract DES is released later in the year.

Whilst the changes to the Network Contract DES may prove to have a more direct impact on primary care, the Bill does include provisions that could have some important implications. Key to those are:

Ultimately there are a lot of unknowns which will need to be addressed either within the Bill as it passes through Parliament or the anticipated guidance that will sit behind the same. Keep an eye on our ICS Hub for developments as and when they happen.

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