NHS long-term plan ‘should give councils greater say on health’

27 Jun 19

Proposals in the long-term plan are too ‘NHS-centric’ and should allow local authorities equal decision-making powers for integrated care systems to work, MPs have said.

Members of the health and social care committee backed plans to scrap rules that currently mean clinical commissioning groups have put out to tender any contract over the value of £615,278. It would be up to CCGs discretion on whether they put out a contracted to tender.  

“We warmly welcome, in principle, NHS England and NHS Improvement’s proposals to promote collaboration, especially the proposal to repeal section 75 of the Health and Social Care Act 2012 and revoke the regulations made under it,” a report by the committee, released on Monday, said.

“We believe collaboration, rather than competition, as an organising principle, is a better way for the NHS and the wider health and care system to respond to today’s challenges,” the MPs said. 

But they added the plan shows “too little consideration” of how the NHS will integrate with other parts of the system, such as local authorities, to provide health care in the future.

Local government was not included in the “main narrative” of the NHS long-term plan and called for the “barriers” to local authority involvement in planning and delivery of services to be removed. 

“Integrated care systems must not repeat mistakes of the past and become unresponsive monopolies or ‘airless rooms’ where non-statutory alternatives are shut out.

“Local authorities must be part of the decision-making process in order for integrated care systems to be truly place-based and focused on population health.”

It added proposals should be brought forward to make councils “equal partners” in joint committees with CCGs and NHS providers. 

On proposals around the competitive tendering rules the committee said: “Competition rules add costs and complexities, without corresponding benefits for patients and taxpayers in return.” 

There have been instances of NHS bodies being sued for failing to use competitive procurement rules properly, as reported by PF last year

Sarah Wollaston, chair of the health and social care committee, said: “Local health providers continue to work to collaborate and integrate care around patients, in spite of current legislative obstacles and these proposed reforms are designed to remove some of the barriers that can get in the way.

“We hope the incoming prime minister will support the need for reform and that a commitment to take this forward will form part of the next Queen’s Speech.” 

The committee also acknowledged the Local Government Association’s recommendation that joint committees should be replaced by Integrated Care System Heal and Wellbeing Boards. 

Ian Hudspeth chair of the LGA’s community and wellbeing board, said: “While we are in favour of measures to enable greater collaboration within the NHS, we want to avoid any legal change which may have unforeseen impacts on collaboration between the NHS and local government.” 

He added: “As stated in this report, legal reforms should allow councils to be equal partners on joint committees alongside CCGs and NHS Providers.” 

Last week, NHS England announced three new ICSs which will service more than 20 million people in England. 

North East and North Cumbria will become the largest ISC in the country while South East London is the capital’s first ICS. A third ISC will be created in Berkshire West. 

NHS England chief executive Simon Stevens said: “These areas are among those showing the real gains of collaboration: helping more people to stay well and avoid needless trips to hospital, while making it easier to get high-quality specialist care.”  

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