A series of documents have been published in support of NHS England’s consultation on the proposed Integrated Care Provider (ICP) contract. They provide details on how the contract would underpin integration between services, how it differs from existing NHS contracts, how it fits into the broader commissioning system, and which organisations could hold the ICP contract.
This development has serious implications for all pharmacists working in the NHS and care systems. A new commissioning landscape is being developed like no other before.
The delivery of health and care services is to be local under the ICP contract, which depends on the following:
- Creation of and publication of shared vision of the system;
- Agreement of common clinical protocols;
- Identification of patients;
- Participation in and signposting to core ICP services;
- Development and maintenance of multidisciplinary teams;
- Development of shared systems and access to information;
- A comprehensive estates plan;
- Development and recruitment of workforce;
- Ensuring that access is appropriate to the need and cost;
- Shared governance of the system.
The imminent development of local primary care networks will require each pharmacy to focus on the aspects of integrated delivery of services, and be fully au fait with the dynamics and politics of the local integrated care system. Working in an engaged multidisciplinary team would require a very different approach: clinical competence; a good ethical approach, not just a legal one; formation of relationships; and digital and other communication skills. In particular, it is important for employers to consider how they, and their employees, can benefit from working in primary care networks to provide more joined-up care for patients and to reduce pressures on the general practice and A&E workforce.
While the national contract might not be in danger of immediate demise, I do not expect the same beyond 2022 at the latest. It defies logic to have a national contract for community pharmacy when all other care is integrated on basis of shared incentives for shared outcomes.
The consultation closes on 26 October 2018, and I feel that every pharmacist needs to consider responding to ensure that they are supported and their collective voice articulated. More information on the consultation is available at: https://www.engage.england.nhs.uk/consultation/proposed-contracting-arrangements-for-icps/
I have articulated a view point and tried to assess what needs to be done. This work is still ongoing, but to avoid delay in consideration of the main points, a document I have prepared is available.
Hemant Patel, secretary, North-East London Pharmaceutical Committee