capitation

  • Manifesto: Tories open to legislation to curb internal market

    From Health Service Journal - 18th May 2017

     

    The Conservative manifesto says the party is open to introducing health legislation if the NHS’s leaders ask for it to help deliver the Five Year Forward View, for example to create new integrated care models.

    It also commits to “review the operation of the internal market and, in time for the start of the 2018 financial year, we will make non-legislative changes to remove barriers to the integration of care”.

    Health secretary Jeremy Hunt told HSJ that the “internal market is too bureaucratic”, and indicated that changes could include a shift to capitation funding, under which providers receive budgets for the care of their entire population, eliminating some commissioner functions.

    The manifesto states: “We will hold NHS England’s leaders to account for delivering their plan to improve patient care.

    “If the current legislative landscape is either slowing implementation or preventing clear national or local accountability, we will consult and make the necessary legislative changes.

    “This includes the NHS’s own internal market, which can fail to act in the interests of patients and creates costly bureaucracy.”

    Over the past year senior NHS figures, including NHS England chief executive Simon Stevens, have indicated that parts of current NHS legislation, including the Health Act 2012, can make it more difficult to develop integrated care and new contracting and organisational models.

    Potential options for legal change range from changing competition and/or procurement law; merging NHS England and NHS Improvement, and potentially other quangos; to creating new NHS structures locally or regionally – potentially eliminating or dramatically reforming the commissioner/provider split.

    The NHS has begun work on developing accountable care structures, but is at a relatively early stage. Many of those involved see it as very difficult within current legislation and rules.

    NHS England is currently working to prepare to announce next steps for the NHS’s first “accountable care systems” shortly after the general election, with up to nine areas of the country

    Comment:   Abolishing the market and purchaser/provider split once new Accountable Care Organisations are in place will cement the regional nature of ACOs and will facilitate capitated funding.  The final step in the regionalization and privatization of the NHS will have been completed.

  • Wake up to the Accountable Care Organisation threat!

    Calderdale and Kirklees 999 Call for the NHS article of 1st March 2017

     

    Simon Stevens, the NHS England Chief Executive,  just told the Public Accounts Committee that some Sustainability and Transformation Plans will soon get going as Accountable Care Organisations or systems.

    This sounds like more tedious, senseless jargonising.

    Indeed one MP, Anne Marie Morris, was so bemused by what Simon Stevens was saying, she asked if they were all smoking dope.

    But behind the jargon smokescreen – whether wacky baccy or not - setting up Sustainability and Transformation Plans to run the NHS as Accountable Care Organisations opens up the NHS to privatisation on a bigger scale than anything seen so far.

    And it is a mechanism for limiting the range of care that the NHS offers, and for denying care to patients who are judged to offer poor value for money.

    This would mean the end of the NHS as a service that provides the full range of health care to anyone who has a clinical need for it.

    How does this work?

    Sustainability and Transformation Plans require the speedy dismantling of the NHS to turn it into a health service that is based on American private health insurance systems – such as United Health,  the former employer of Simon Stevens, now NHS England’s Chief Executive.

  • GP superpractice tries to buy hospital and recruit GP trainees from China

    Neil Roberts on the 2 December 2016  - Superpractice in talks to buy hospital and recruit GP trainees from China - GPonline.com

    A 100,000-patient GP 'superpractice' in an NHS vanguard area plans to buy a hospital from a struggling foundation trust, and is in discussions with China about bringing medical students to train in England.

    Robert Harris, chief executive of the Lakeside Healthcare group of practices - one of the biggest GP partnerships in England - is due to meet Chinese officials next week with a view to bringing students to train in its practices. The organisation is also planning a similar scheme for India and plans to buy a hospital from a foundation trust which is in financial difficulties, Mr Harris revealed.

    Speaking at a Westminster Health Forum event in central London on Thursday Mr Harris said the superpractice, which is developing a vanguard multi-specialty community provider (MCP) around its five Northamptonshire practices, wanted to become a teaching and training practice of repute.

  • Julia Simon: "STPs and ACOs: solutions for a 'bankrupt' NHS and social care system"?

    Talk given at the Learie Constantine centre, Dudden Hill Lane, on 1st December 2016 at the invitation of Brent Patient Voice to an audience of 50 people.

    Dr Julia Simon was until Sept 2016 the head of NHS England's commissioning policy unit and its programme director of co-commissioning of primary care.

    She had worked at London and national NHS level since 2012 on CCG and commissioning issues.

     

    Dr Simon referred to a small number of presentation slides.

    "There has been a split between commissioning and provision for over 25 years. The 2012 Health and Social Care Act aims to create a truly clinically led system with GPs in the driving seat. But the outcome is actually a fragmented commissioning system with three main budget holders across CCGs, NHSE and local authorities (public health), and a bewildering number of other national organisations.

    In my view healthcare isn't a market: hospitals do not fail. They are always bailed out in order to give citizens care - which seems obvious. Andrew Lansley, the Secretary of State for Health responsible for the introduction of the HSCS Act, is married to a GP.

    CCGs:

    There were 212 in 2012 and there are 209 now. They are legally constituted by their members and all practising GPs must be members of one. CCGs have a statutory duty to (1) improve primary care and (2) to engage citizens.

    Fragmentation:

  • Public meeting on Tuesday 29th November, 7pm, at Town Hall: H&F rejects NHS "STP" plans to downgrade Charing Cross and Ealing

    Please come to a public meeting at 7pm at Hammersmith Town Hall on Tuesday 29th November to hear and discuss the response of H&F Council to the latest proposals for cuts in health services in NW London called the "Sustainability and Transformation Plan" or STP.

    The plan involves a complete upheaval of every service, from community care to mental health services to GPs to A&E departments to acute beds in the major hospitals, in NW London. The central aim of the plan is, we are told, to save money: a staggering £1.3 billion over the period to April 2021.

    Hammersmith and Fulham Council strongly opposes the STP and has voiced its opposition to the NHS bodies concerned.