NHS Restructuring

Many people may not have noticed but the structure of the NHS has changed. The intention of the re-organisation is to improve the co-ordination of work between General Practitioner’s, Community Services and the Hospitals. There is also a desire to prevent ill-health, the address factors affecting health and wellbeing such as obesity.

Following the NHS five year forward view published in 2014 many areas developed sustainability and transformation plans (STBs). These STBs are now being developed into integrated care systems (ICs). In England there are 42 ICs in charge of local NHS commission and spending.

Integrated Care boards (ICBs) undertake the delivery of an ICs plan. The ICPs are alliances of NHS providers intended to work together to deliver care by collaborating rather than competing. These include hospitals, community services, mental health services and General Practitioner. Social care and independents in the third sector providers may also be involved.

Clinical Commission Groups will no longer exist although primary care networks will.

The intention to create a linked up system for the delivery of health is laudable.

There are a huge number of pressures on the NHS. Staff recruitment and retention is poor leading to huge pressures on the work force. An aging population and the increasing amount of treatment that can be offered are leading to spiralling costs. There is currently not enough provisional social care in the community, preventing discharge of patients from hospital, in part leading to the long wait that seem a daily feature of our Accident & Emergency Departments.

I fear we are just re-arranging the deck chairs on the Titanic.