Reform joins up care

David Hare explains what the new Health and Care Act means for independent practitioners.

At the end of April, the Health and Care Bill completed its passage through Parliament and will now establish some of the biggest reforms to how the healthcare system operates in almost a decade. 

While the bill has largely gone under the radar during the last year due to Covid and the rising elective care backlogs, the new legislation contains a number of key reforms which will change the safety and quality landscape for independent providers and practitioners.

The most significant change in the now Health and Care Act is the abolition of clinical commissioning groups (CCGs) and the introduction of integrated care systems (ICSs) from 1 July.

This will bring together local providers who will have a much greater role in shaping local healthcare provision and commissioning new services. 

As part of this change, regulation of healthcare services will also move to what is described as a more ‘systems’ level. 

While the Care Quality Com­mission (CQC) will continue to inspect individual services, the new Act includes a requirement for it to conduct reviews of ICSs.

The watchdog will look broadly across the system to see how integrated care boards – who will commission care – local authorities and providers of health, public health and adult social care services are working together.

Working in practice 

While this makes sense in principle and should ensure that ICSs can be held accountable for the decisions they make that affect the quality and safety of care their local area, it throws up a huge range of issues around how it can work on a more practical level. 

For example, what exactly will the CQC be assessing at ‘system level’? 

If patient outcomes are poor in a particular area, to what extent can it be determined that this is down to an individual provider or the ‘system’ they work within? 

And could this lead to duplication in assessments taking place across local areas? 

Moreover, in assessing how well providers ‘work together’, how can it be demonstrated that more ‘collaborative’ working is actually making a difference to patient care on the ground? 

There are not going to be any easy answers to this, and we will be continuing to engage with the CQC to ensure the needs of independent healthcare providers and those working in the sector are fully factored into this new way of working.

Share information

A more ‘integrated’ approach to regulation and inspection is also mirrored in the data world with the Health and Care Act setting out new powers for health or social care bodies in England to share information. 

The idea is that this will help ensure that data relating to all health services – including those delivered by independent sector providers – flows through the system in a standardised way so that it is always meaningful and easy to understand for any recipient or user. 

In turn, it is hoped this will help improve the experience of patients who move between publicly and privately funded services; for example, such as individuals who receive their elective surgery in a private provider. 

By encouraging the frictionless movement of information between providers, this will ultimately support timely and appropriate patient care decisions, something which IHPN has been calling on for some time.

David Hare (right) is the chief executive of the Independent Healthcare Providers Network (IHPN)