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ICSs will lead to less competition, says NHS

ICSs will lead to less competition, says NHS
21 March 2018

Integrated Care Systems (ICSs) will lead to ‘less competition’, NHS England has said.

Speaking before the Health Committee on 20 March, NHS chief executive Simon Stevens said that ‘we’ll see less competition as a result of integrated care changes’.

He continued: ‘We’ll probably see a significant decrease in the number of services that are subject to procurements.

‘At the moment, as community health services in particular are subject to periodic reprocurement – to the extent that they are part of an integrated care delivery service with hospital specialist services and GP services – they won’t be subject to that three or five yearly re procurement cycle.’

Ongoing process

Mr Stevens said that matters such as the potential exclusion of the private sector in ICS contracts are currently ‘before the court’.

He added: ‘As our work develops with ICSs, it will be clear that where there are friction points, we’ll be very happy to give you [the Health Committee] more chapter and verse on some of that at the right time.

‘Our consultation paper will make very clear the answers of the questions while being clear that we’re fully compliant with the law as it currently stands.’

Amending the law?

Health Committee member Steve Barclay suggested to introduce ‘a simple one-closed bill’ to rule out private firms from winning current accountable care organisation (ACO) contracts.

But health minister Stephen Barclay – also speaking before the Committee – said that it ‘wouldn’t be necessary as there are ‘checks and balances in the system’.

He continued: ‘We don’t see private firms actually securing ACOs in the first place.

‘The contract will sit with the Clinical Commissioning Group (CCG), which will retain the statutory responsibility as the commissioning body.

‘The idea that this is looking to some sort of American model is simply not borne out in the legal position.’

 ‘Not a silver bullet’

Mr Stevens said that ‘the move towards more integrated services is not a silver bullet but part of the answer to a well functioning and sustainable NHS’.

He added: ‘We also need a properly resourced NHS.

‘If we had trend rates, we would be receiving £8.8bn more next year than we’re actually going to.

‘Looking out over the next five or ten years, we’re going to have to return closer to the trend funding growth the NHS has had for the majority of its history.’

According to the National Audit Office (NAO), NHS average funding has increased by 3.7% a year since 1948 but will increase by around 2% between 2014/15 and 2020/21.

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