A complicated commissioning system, the nature of contracts available and the struggle to access capital could thwart the voluntary sector’s ambition to be a major player in the new NHS landscape.
At an NPC event held this morning there was optimism about the planned shift from episodic to integrated care, something many in the voluntary sector have been advocating for years. A large number of health charities already offer integrated care in their communities, which helps people to manage their long term health conditions such as diabetes and multiple sclerosis. This in turn dramatically reduces their chances of needing expensive acute hospital care.
Speakers at the event talked of ‘accountable lead providers’ needing to take responsibility for the development and delivery of integrated care pathways if they are to work, and the audience of charities had their concerns.
In my view, there seems to be a strong belief that the new NHS will involve a shift away from acute and episodic care towards integrated care pathways, potentially good news for the voluntary sector. This push should come from the new clinical commissioning groups (CCGs), from the National Commissioning Board with its new Mandate and from the regulator, Monitor.
But the irony is that the voluntary sector may be squeezed out of being a provider in this new world unless it can get to grips with the complexity of the new system, the necessity of proving that its work has impact and access to capital. There is a fear that the accountable lead providers appointed by CCGs will in effect operate like prime contractors in the Work Programme, bringing with them all the problems we have seen for the voluntary sector in the welfare to work scheme.
If good voluntary sectors providers are sidelined it would be not be a good outcome for patients and we think it very important that the government and health regulators keep a close eye on this.
Read about and comment on the discussions on the day here. And watch a summary video of what was said: