Government paves way for integrated care providers to be set up

The Department of Health and Social Care has announced that it is introducing changes to the law to make it easier for new integrated care organisations to be set up.

At present, it is complicated for different NHS organisations to come together and deliver properly integrated care while each body holds its own independent contract with commissioners. However, the changes being introduced to existing secondary legislation by the government will allow services to be brought together through a single contract delivered through new organisations known as integrated care providers, or ICPs.

Setting up an ICP will typically allow primary medical services to be run through the same contract as other health and care services, such as hospital services and social care. This should allow care to be better coordinated by a single organisation around the needs of the individual. Care will also increasingly be delivered by the new organisations in the community and in people’s homes, improving access to services and reducing trips to hospital.

Making the ICP contract available for use from 2019 was confirmed by NHS England in the NHS Long Term Plan. The government states that contracts are expected to be held by statutory providers, such as NHS foundation trusts. GPs who wish to integrate with an ICP will be able to do so easily if they choose to, simply by transferring their services from previous contracts to the new ICP contract. The legal changes being introduced by the government this month will ensure that ICPs follow the same rules as other NHS or care organisations, for example around complaints procedures and the reimbursement of travel expenses, etc.

A move by an individual practice or GP to join an ICP will be entirely voluntary, the government stresses, and their role in an ICP will be for them to decide. Before the first contracts are awarded proposals are expected to be scrutinised through integrated support and assurance processes.

Announcing the changes, Minister for Health Stephen Hammond said:

‘As part of our Long Term Plan for the NHS, which is backed by £20.5 billion extra a year by 2023 to 2024, we want to make sure care fits around patients and not the other way around. These new regulations are a crucial step towards more integrated care for patients in England.

‘Integrated care providers will give local areas the power to integrate care by bringing all the different healthcare services provided to local residents into a single contract.

‘For patients, it should mean fewer trips to hospital and more care in the community, and allows health and care services to work together seamlessly with a greater focus on preventative, proactive and coordinated care.’

The government is taking action following a number of publications and consultations during 2018.

The implications of commissioning ICPs for Clinical Commissioning Groups (CCGs) in England were spelled out in a consultation package published in November 2018, CCG roles where ICPs are established. The paper describes how CCGs will continue to be responsible and accountable for the delivery of their statutory duties and powers and sets out the legislative framework for pooling budgets for NHS, social care and public health services.

Alongside the CCG paper was a Draft ICP Contract and further supporting documents.

The consultation documents can be found at https://bit.ly/2Tbvas4.

An additional consultation covered Integrated Care Provider Directions, describing the mandatory requirements on providers of GP services who choose to participate in a new integrated care provider (ICP) contract.