Source · Select Committees · Health and Social Care Committee
Recommendation 23
23
Deferred
Paragraph: 89
Government and NHS England must acknowledge declining continuity of care and prioritise its reversal.
Conclusion
The Government and NHS England must acknowledge the decline in continuity of care in recent years and make it an explicit national priority to reverse this decline.
Government Response Summary
The government partially accepts the recommendation but discusses current and ongoing work to explore gain sharing agreements and financial incentives to reward primary care for reducing secondary care expenditure, rather than making continuity of care an explicit national priority.
Paragraph Reference:
89
Government Response
Deferred
HM Government
Deferred
Partially accept. The Department partially accepts this recommendation. We appreciate the sentiment of sharing the rewards of cost reductions where primary care has had a part to play. NHS England can provide light touch support for Integrated Care Systems (ICSs) to implement gain sharing, for example by way of sharing appropriate case studies. The difficulties in proving causality of reduction in expenditure mean that a gain sharing agreement where funds are taken from secondary care and given to primary care would not always be suitable. In addition, whether savings can be extracted and redistributed depends on the nature of provider contracts locally as well as the underlying fixed and variable costs. However, there are already mechanisms in place which reward primary care where it supports the reduction of secondary care expenditure. ICSs have been designed to have an overview of the whole system so that resources are used most effectively across primary, secondary, community and social care. Within an ICS, savings made in one area typically contribute towards overall system control totals. Work is ongoing to consider additional opportunities to reward primary care for actions taken to relieve pressure on secondary care. The recovery plans sets out that NHS England will explore alternative approaches that can work alongside the partnership model and explore additional opportunities to better align clinical and financial responsibilities in primary care, enabling primary care teams to shape NHS services in their area and reinvest savings in frontline services.