Primary care bodies outline key ‘asks’ on the Health and Care Bill

Representative bodies from across NHS primary care have set out key ‘asks’ as the Government’s Health and Care Bill enters committee stage.

Submitted by the British Medical Association, British Dental Association, Pharmaceutical Services Negotiating Committee, Optometric Fees Negotiating Committee (OFNC), and the National Community Hearing Association, the primary care ‘asks’ aim to “ensure integrated care happens through engagement with primary care providers at all levels.”

As part of the OFNC, the national negotiating body for eye care in England, the AOP has highlighted the opportunities the new framework could hold but emphasised the need for optometry to have a place “at a strategic level.”

The organisations call on the bill committee to ensure the Government honours its commitment for primary care to be represented and involved in decision making at all levels of the Integrated Care Systems (ICS), including formalised roles for members of primary care in Integrated Care Partnerships (ICP).

They also ask that roles are remunerated to ensure parity of availability and voice with NHS Trusts, NHS staff, social care and public health colleagues, and that existing Local Representative Committees have the right to put forward nominations for roles. The representative bodies also request that ICBs and ICPs have a duty to explain in public writing when they choose not to observe advice from local primary care bodies.

The joint letter sets out primary care’s role in the NHS, support for reform, and the need for primary care to have a voice.

Providing a view of what would be needed for optometry, AOP chief executive, Adam Sampson, commented: “The new design framework for NHS integrated care systems offers important opportunities that optometry must capitalise on.

“More consistent commissioning of extended eye care services is a prime example of improved patient care and better use of the highly skilled practitioners in optics,” he shared, continuing: “But it is essential that optometry has a place at the table to input at a strategic level in order to create real transformation, reduce pressure on the NHS, and deliver robust and sustainable eye care for all.”

Earlier this year, a number of representative bodies in primary care, including the AOP, called on the Government to ensure wider primary care services beyond general practice would have a voice in the new NHS systems proposed in the bill.

The AOP also identified potential risks in the reforms around the GOS commissioning in February and has committed to “continue to work with others in the sector to manage those risks.”

In a document of ‘asks’ for the bill committee, the representative bodies outlined support for reform, writing: “Primary care fully supports better integrated health and social care, a focus on prevention and early intervention, and shaping services around the needs and wishes of individual patients and populations – this is how primary care already operates.”

Welcoming plans to retain national contracts and negotiating mechanisms for primary care, the document also illustrates that budgets must be protected and increased to meet needs and deliver more care closer to home. It also suggests existing NHS primary care practices should be the ‘go to’ for expanding NHS capacity outside of hospitals.

For these reasons, the representative bodies highlighted, “It is vital that clinical representation and engagement from across primary care is embedded at every level of the new Integrated Care Systems, especially at strategic decision-making level.”

“Without that, genuine change and service transformation will not happen,” the organisations cautioned, adding, “ICBs and Integrated Care Partnerships already have the backlog and the lasting effect of the pandemic to deal with and, without primary care engagement as equal partners at the table as of right, recovery will be seriously impeded, opportunities missed, and serious transformation will not happen.”

The ‘asks’ highlight the important role that Local Representative Committees (such as Local Optical Committees) have played in the NHS, suggesting this must be recognised through formalised roles within ICPs.

The representative bodies also address workforce planning, and what is needed to ensure sufficient primary care professionals to meet the needs of the population in the future. The document highlights concerns that major re-organisation could lead to experienced staff leaving the NHS, emphasising the need for support and an increased focus on retention.