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nhs-nurseOctober 27 2014

NHS England has set out a five year vision for the NHS calling for a “radical upgrade” in prevention and public health.

There will be “hard-hitting national action on obesity, smoking, alcohol and other major health risks,” along with new workplace incentives, and more advocacy for local government and elected mayors to have stronger health related powers.

The Five Year Forward View is a collaboration between six leading NHS groups including Monitor, Health Education England, the NHS Trust Development Authority, Public Health England, the Care Quality Commission and NHS England.

The document says “the NHS will take decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care.”

It will also encourage more diversity in its care models. “One new option will permit groups of GPs to combine with nurses, other community health services, hospital specialists and perhaps mental health and social care to create integrated out-of-hospital care - the Multispecialty Community Provider,” says the report.

“Early versions of these models are emerging in different parts of the country, but they generally do not yet employ hospital consultants, have admitting rights to hospital beds, run community hospitals or take delegated control of the NHS budget.

“A further new option will be the integrated hospital and primary care provider - Primary and Acute Care Systems - combining for the first time general practice and hospital services, similar to the Accountable Care Organisations now developing in other countries too.”

The report also says there needs to be a ‘new deal’ for GPs. “Over the next five years the NHS will invest more in primary care, while stabilising core funding for general practice nationally over the next two years.

“GP-led Clinical Commissioning Groups will have the option of more control over the wider NHS budget, enabling a shift in investment from acute to primary and community services. The number of GPs in training needs to be increased as fast as possible, with new options to encourage retention.”

Launching the document, NHS England’s chief executive Simon Stevens said: “It is perfectly possible to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure the future that we know is possible, the NHS needs to change substantially, and we need the support of future governments and other partners to do so.

“We need to get serious on three fronts: we need to take our own health seriously, change the way services are provided, and yes ask the next government to support us financially to carry on delivering high quality services.

Mr Stevens said the Forward View is not a blueprint for care throughout the entire country, adding: “England is too big for a one-size-fits-all plan, and nor is the answer to simply let ‘a thousand flowers bloom’. It’s horses for courses.”

Responding to the launch of the document, Dr Richard Vautrey, Deputy Chair of the BMA’s GP committee, commented: “It is encouraging that NHS England’s Five Year View recognises the issues facing general practice and politicians must now act urgently to deliver its proposals.

“On new ways of working, the BMA has already been supporting groups of practices who are working together in larger structures. However, there is no one perfect model for this and one size does not fit all. The same applies to hospitals taking over GP practices.

“This may be the only possible option for some practices struggling to remain viable – such as a small number of remote, rural GP practices, but there is little evidence that this is needed or necessary for most of the country and could make matters worse for patients rather than improve services.”

Dr Maureen Baker, RCGP Chair, added: "“The recommendations of this report chime with much of what we have proposed already. The findings of the Independent Inquiry into Patient Centred Care will also be out shortly, and we look forward to examining how these fit together with the proposals unveiled today.

“We strongly support the need for new models of care, particularly for GP practices to work within federations. However, models under which GPs are made employees of hospitals – and therefore can no longer independently advocate for their patients – should only be considered if there is very good evidence for doing so.

Links:

Five Year Forward View document

NHS England statement

BMA response

RCGP response

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