BMJ 2015;350:h1512 doi: 10.1136/bmj.h1512 (Published 19 March 2015)
Page 1 of 2
News
NEWS Hospitals must take lead on new care models and work better with GPs, think tank says Gareth Iacobucci The BMJ
Acute care hospitals in England must avoid adopting a “fortress mentality” in the face of financial and workload pressure and instead focus on new models of care and improving relationships with general practice, a healthcare think tank has urged. In its new report the King’s Fund acknowledged that NHS hospitals were facing mounting service and financial pressure but said that they should look beyond merely safeguarding their own organisations and focus on leading system-wide changes that improved services for all patients.1 It said that better relationships between hospital leaders and GPs was crucial to the new models of integrated care described in NHS England’s Five Year Forward View, published in October last year.2 The think tank also argued that hospital trusts should be collaborating more with neighbouring hospitals and taking on a bigger role in prevention and public health.
Using case studies from five areas of England, the report found that some hospitals had already made substantial progress in this area by investing “considerable time and energy in building relationships with community partners, often over several years.” But it said that in other places hospitals had more work to do in improving relationships and fostering new ways of working. Chris Naylor, senior fellow at the King’s Fund and a coauthor of the report, said, “We are seeing an important shift in thinking in some acute trusts. Hospital leaders are telling us that they see their role increasingly in terms of system leadership and that working closely with local partners is key to the survival of the services they provide.
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“However, the picture varies across the country, and even in those areas where most progress has been made there is still a long way to go before the new models of care described in the forward view can become a reality.”
He added, “One critical area where rapid progress is needed is improving the relationship between hospitals and primary care—this has all too often held back successful integrated care.”
The report also gives other recommendations to enable new ways of working in the NHS, including a new regulatory model that puts more emphasis on whole system performance and ensuring that competition law does not hinder constructive dialogue and partnership between commissioners and providers. It also urges the NHS to continue developing alternative payment systems and to help local commissioners move away from activity based tariff payments for hospital services. In addition, it suggests developing more flexible contracting models for general practice, to enable acute care providers to play a bigger part in primary care provision. 1 2
Naylor C, Alderwick H, Honeyman M. Acute hospitals and integrated care: from hospitals to health systems. King’s Fund 19 Mar 2015. www.kingsfund.org.uk/acutehospitals. Iacobucci G. NHS plan calls for new models of care and greater emphasis on prevention. BMJ 2014;349:g6430. http://www.bmj.com/content/349/bmj.g6430.
Cite this as: BMJ 2015;350:h1512 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
BMJ 2015;350:h1512 doi: 10.1136/bmj.h1512 (Published 19 March 2015)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 2
News
NEWS Hospitals must take lead on new care models and work better with GPs, think tank says Gareth Iacobucci The BMJ
Acute care hospitals in England must avoid adopting a “fortress mentality” in the face of financial and workload pressure and instead focus on new models of care and improving relationships with general practice, a healthcare think tank has urged. In its new report the King’s Fund acknowledged that NHS hospitals were facing mounting service and financial pressure but said that they should look beyond merely safeguarding their own organisations and focus on leading system-wide changes that improved services for all patients.1 It said that better relationships between hospital leaders and GPs was crucial to the new models of integrated care described in NHS England’s Five Year Forward View, published in October last year.2 The think tank also argued that hospital trusts should be collaborating more with neighbouring hospitals and taking on a bigger role in prevention and public health.
Using case studies from five areas of England, the report found that some hospitals had already made substantial progress in this area by investing “considerable time and energy in building relationships with community partners, often over several years.” But it said that in other places hospitals had more work to do in improving relationships and fostering new ways of working. Chris Naylor, senior fellow at the King’s Fund and a coauthor of the report, said, “We are seeing an important shift in thinking in some acute trusts. Hospital leaders are telling us that they see their role increasingly in terms of system leadership and that working closely with local partners is key to the survival of the services they provide.
For personal use only: See rights and reprints http://www.bmj.com/permissions
“However, the picture varies across the country, and even in those areas where most progress has been made there is still a long way to go before the new models of care described in the forward view can become a reality.”
He added, “One critical area where rapid progress is needed is improving the relationship between hospitals and primary care—this has all too often held back successful integrated care.”
The report also gives other recommendations to enable new ways of working in the NHS, including a new regulatory model that puts more emphasis on whole system performance and ensuring that competition law does not hinder constructive dialogue and partnership between commissioners and providers. It also urges the NHS to continue developing alternative payment systems and to help local commissioners move away from activity based tariff payments for hospital services. In addition, it suggests developing more flexible contracting models for general practice, to enable acute care providers to play a bigger part in primary care provision. 1 2
Naylor C, Alderwick H, Honeyman M. Acute hospitals and integrated care: from hospitals to health systems. King’s Fund 19 Mar 2015. www.kingsfund.org.uk/acutehospitals. Iacobucci G. NHS plan calls for new models of care and greater emphasis on prevention. BMJ 2014;349:g6430. http://www.bmj.com/content/349/bmj.g6430.
Cite this as: BMJ 2015;350:h1512 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
BMJ 2015;350:h1512 doi: 10.1136/bmj.h1512 (Published 19 March 2015)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
