Government responds to Lords committee report on integrating primary and community care

The Department of Health and Social Care has formally responded to recommendations made by the House of Lords Integration of Primary and Community Care Committe's report Patients at the centre: Integrating Primary and Community Care, published on 15 December 2023. A summary of the response is as follows:

1. Maturity of ICSs: the Government agrees with giving ICSs time to mature, avoiding further reorganisation of the health service. It has commissioned an independent research study to evaluate the implementation of the Health and Care Act and the effectiveness of ICS structures in promoting integration. This study would inform any future reforms.
2. Membership of ICSs: the Government supports the inclusion of elected local government officials and representatives from VCSE organisations in ICBs and directors of public health as statutory members of ICPs. This approach aims to strengthen local representation and integration efforts.
3. Accountable Officer: the Government is considering the proposal for a single accountable officer at the local level and plans to provide more details on how this role would address local health needs and be subject to scrutiny.
4. Coterminosity: the Government supports the aim of aligning ICS and local authority boundaries as a long-term goal to facilitate integration and simplify the merging of health and social care budgets.
5. Integration Index: the Government agrees with the development of an 'integration index' by the CQC to evaluate ICSs' coordination of services, emphasising the importance of joint education and training for integration.
6. Pilot Studies Review and Engagement: the Government acknowledges the value of disseminating and reviewing CQC pilot studies to improve the inspection regime for ICSs and ensure alignment with the Health and Care Act.
7. Reforms in Primary and Community Care Contracts: the Government plans to reform and align primary and community care contracts to incentivise integrated working, with flexibility for ICBs in commissioning primary care and funding based on health outcomes.
8. Ownership Models of GP Practices: the Government is exploring different ownership models for GP practices to support multi-disciplinary working and integration with community services.
9. Better Care Fund: the Government is considering enhancing the Better Care Fund and devolving statutory responsibilities to place-based commissioners to better address local health and social care needs.
10. Place-Level Committees: the Government does not see the need for statutory requirements beyond the current framework for place-level committees but acknowledges the importance of local decision-making and integration.
11. Data Collection and Portability: the Government commits to publishing high-level guidance to standardise data collection and enhance interoperability across healthcare and local government systems.
12. Interoperable Data Systems: the Government supports the development of interoperable data systems through national commercial negotiations to facilitate single patient records and reduce costs.
13. Data and Privacy Law Guidance: the Government has published guidance on data and privacy laws to clarify their application to patient data and support clinicians in data sharing.
14. Training for Integration: the Government recognises the importance of protected training time for integration and is considering deviating training budgets to local levels.
15. Independent Prescribing and Referral Rights: the Government is expanding independent prescribing and referral rights to more community disciplines to reduce demand for GPs and improve patient care.
16. Training of Social Care Workers: the Government invests in training and professionalisation for social care workers to perform basic nursing procedures and work effectively in multi-disciplinary teams.

The Government's response says the Committee's report underscores the critical importance of primary and community services for the successful integration of care for patients and sets out a helpful framework for the challenges facing the integration of care, Many of its conclusions resonate with the government’s own engagement with ICSs and the organisations within them.