The White Paper itself was built on the recommendations made by NHS England and NHS Improvement regarding integrated care as well as attempts to remove bureaucracy.
- the health and well-being of the people of England
- the quality of services provided to individuals by relevant bodies, or in pursuance of arrangements made by relevant bodies, for or in connection with the prevention, diagnosis or treatment of illness, as part of the health service in England
- efficiency and sustainability in relation to the use of resources by relevant bodies for the purposes of the health service in England
- the integrated care board for its area
- NHS England
- the responsible local authorities whose areas coincide with or fall wholly or partly within its area
Of key interest to general practice will be how primary care is represented in the decision-making process. PCNs have been described as the foundation of ICS and whilst one GP member is required to sit on the ICB, the BMA has flagged the importance of clinical leadership at each level of the ICS and, noting the ability of the ICB to make additional appointments, is arguing for greater GP representation on the ICB as well as other clinicians and LMC representatives. It is expected that the role of primary care networks within an ICS will be prescribed by NHS England at a future date. Concerns have been raised from a range of stakeholders around the future of funding in primary care when the current five-year contract arrangements ends, particularly with the development of pooled budgets and whether this might extend to include funding currently allocated to primary care.
The Bill also looks to remove current requirements around procurement and competition. Whilst this has been welcomed by NHS providers, there is no guarantee that this will mean NHS providers being guaranteed NHS contracts and could equally be used to award contracts to private contractors more easily. Much focus will fall on how the procurement regime will develop and whether this will benefit or detriment NHS providers.