The Royal College of Physicians (RCP) welcomes the prime minister’s commitment to the integration of services. We believe that a commitment to give hospital doctors a role in local commissioning bodies is essential to achieve the best quality care for patients, and comprehensive and efficient health services for all.
It is crucial that hospital and public health doctors have a mandated place on the board of local commissioning bodies to guarantee the highest level of involvement across the country. To encourage further integration, the RCP wants GPs to sit on the boards of foundation trusts. These changes will enable different types of doctors to work together to improve patient care. The new proposed clinical senates must deliver the same effect otherwise they will fall short of what is required.
The RCP believes that to ensure true integration, consortia should be renamed community commissioning boards to reflect the broader involvement of health professionals and patients. They must have strong links with clinical networks in their local area to ensure commissioning always produces integrated services, based on best practice.
The RCP welcomes the new role for Monitor of promoting integrated care, but still has concerns about its major role in promoting competition. Instead we would like to see Monitor promoting integration through collaboration and a focus on quality.
Sir Richard Thompson, RCP president, says:
We are pleased that the government paused the progress of the Bill to listen to patients and health professionals. Quality, collaboration and integration must be at the heart of the health service and these principles – not competition – should be the focus of health service regulators. The government must take this opportunity to amend the Health and Social Care Bill so that patient safety and integrated care are at the heart of the reforms. This can only be achieved with a commitment to include hospital doctors on commissioning boards, and robust arrangements for involving specialists at a national level. The RCP looks forward to the NHS Future Forum’s report on improving the Health and Social Care Bill in the coming weeks.
The reforms must also take into account the findings of the Francis Inquiry; the public inquiry into the instances of sub-standard care at Mid Staffordshire Foundation Trust between 2005 and 2009. Improving patient safety must be at the core of changes to the NHS.
On medical training, Sir Richard went on to say:
The RCP also has concerns with the proposed changes to postgraduate medical training. All medical training must be quality assured and nationally planned. Consultants’ training is expensive and extensive, changes must not be rushed. We are calling for the government to put any reforms to doctors’ training on hold for at least two years so that these changes can be properly implemented.