Long read
The Health and Care Act:
six key questions
The Health and Care Act, which introduces significant reforms to the organisation and delivery of health are care services in England, received Royal Assent in April 2022. In this long read, we explain what the changes brought in by the Act mean in practice.
Comments
I agree the primary/secondary care interface in UK is currently a big barrier.
Also capitated budgets send shivers down my spine- demand continues and will inevitably continue to increase on NHS and social care- one cant continue to do more for the same. GPs currently work on a capitated budget (GMS/PMS) and this model is failing.
A third issue which gets very little air time is the fact GPs and partners are governed by partnership law, which many commentators are either ignorant of or fail to address ie if we go bust we are 'jointly and severally liable' for any costs ie redundancy/property debt and therefore are at risk of personal bankruptcy- yes it has and does happen to GPs. We cannot hold a GMS/PMS contract within another business vehicle unlike every other provider in the wider system which would help alleviate this risk (it puts nearly all newly qualified docs off becoming partners in our uncertain politicised NHS. Could Kings fund point me to any experience of how partnerships (and the risks they carry) have been incorporated into ACOs?
http://www.kingsfund.org.uk/projects/nhs-five-year-forward-view
Key elements for me are leadership, followership, ownership and partnership and getting over the' what’s in it for me' re funding barriers and focusing a more 'can do' ethos on 'we're in it together'. Sorry to digress but my train of thought on the current challenges about accountability and the quality of care tend to lead me to these points more often than not.
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