David Lock on integrated care experiments: at last some sensible thinking from the government for the NHS

The HSJ reports that the government is about to signal a series of large scale integrated care “experiments,” which could result in a movement away from the straightjacket of payment by results, with all of the biases towards activity, and away from prevention that have been reported on so often. Is this a first step towards NHS Acute Trusts being paid for keeping patients with long term conditions out of hospital instead of paying to treat patients if they attend hospital?

The HSJ reports that:

“The project to enable services to be brought together in health economies, beginning in the first half of next year, was discussed last week when health minister Norman Lamb convened a round table meeting at the King’s Fund in London. This was attended by leading figures from Monitor, the NHS Commissioning Board, local government, and patient groups.”

This is really good news and, if it works, will be a win-win for patients, clinicians, and NHS administrators. This is precisely the type of integrated care across multiple providers that the NHS needs, and which requires good planning and co-operation to deliver.

However it would be churlish to point out to the minister that this is the complete opposite of the fragmented, market driven reforms that ministers forced on the NHS through the procurement regulations which were debated in Parliament last week.

Is this a tiny step back towards an NHS that will work in a joined-up way, and an NHS that will work in the interests of patients?  I very much hope so.

David Lock is a barrister and QC, No5 chambers. He is a board member of of Brook Sexual Health, a member of the BMA Ethics Committee, and a Honorary Professor at University of Birmingham.

Competing interests: I am a member of the Labour Party and Chair the West Midlands Branch of the Labour Finance and Industry Group. I am due to become a non-executive Board Member of Heart of England NHS Foundation Trust which is due to commence on 1 June 2013. My wife is a doctor who is employed by Worcestershire Partnership NHS Trust.