Integration of Primary and Community Care Committee. Patients at the centre: integrating primary and community care (15 December 2023)

Summary

A lack of coordination between the everyday primary and community services relied on by people using the NHS is leading to sub-standard care, missed opportunities for home or community-based treatments, and undue strain on hospitals that are already overstretched. There must be significant reform in terms of better staff training, improved data-sharing, flexible healthcare structures and collaboration across different professions in the healthcare system. These reforms will realise the potential of an integrated NHS and deliver more efficient healthcare services ensuring value for money and satisfied, healthier patients. This is the major conclusion of the report 'Patients at the centre: integrating primary and community care'.

This report highlights the need for a seamlessly integrated patient-centric healthcare sector where patients are given the type of care they need, when, where, and how they need it; whether that be access to a GP, a pharmacist or a district or mental health nurse. The Government should focus more on preventative rather than reactive care to tackle the needs of an ageing population, many of whom are coping with complex health issues requiring intricate and continuous care.

Content

Key recommendations within the report include:

• Structures and organisation of NHS services need to be streamlined. Integrated Care Systems (ICSs) are a good starting point for collaborative working but their relationship with other healthcare bodies, public bodies, and local government must be based on mutual professional respect. The Department of Health and Social Care (DHSC) should evaluate ICS structures before implementing any major health service reforms.
• There needs to be a more simplified and flexible system for awarding contracts and allocating funds within the NHS to encourage multi-disciplinary, integrated working. DHSC and NHS England (NHSE) should reform the contract process and ensure new contracts are flexible in the commissioning of primary care. The Government should explore different ownership models for GP practices to facilitate more joined-up and better care.
• Efficient data-sharing is crucial to successful healthcare integration. Fragmented systems often require patients to repeatedly provide the same medical information, causing frustration. A properly maintained Single Patient Record (SPR) and the ability for intersectoral data-sharing between healthcare professionals are essential to tackle this issue. The DHSC must issue guidance to standardise data practices and clarify data sharing within privacy laws, to ensure timely patient access to medical data.
• Equipping staff to work across multiple clinical disciplines through improved training will make integration of services easier. Currently, staff spend more time meeting everyday demand, rather than implementing new integration strategies. Clinicians should be introduced to the work of other services through job rotations. Social care needs should also be included in the NHS's Long Term Workforce Plan to ensure that enough well-trained social carers are available.