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Leaders ‘worried’ about lack of local support for integrated care

Mentoring relationship

By Jess Hacker
16 November 2021

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As many as three-quarters (75%) of trust leaders are not confident or ‘worried’ about the local support in place to support a more integrated service between primary and secondary care, a new report has shown.

Published today (16 November) by NHS Providers, the report indicated that 33% of trust leaders were ‘worried’ and 10% ‘very worried’ about the support available.

A further 32% of leaders from the 114 trusts who responded said they were neither confident nor worried, with only 1% stating they felt very confident.

Those who felt worried or not confident cited the extreme pressures which primary care services are under as a major concern, while others flagged that the effects of integration are not yet visible.

Additionally, nearly nine-in-10 (87%) respondents said they were extremely concerned about the impact of seasonal pressures over winter on their trust and local area.

The findings come as GP practices and the NHS prepare for what has what is expected to be ‘the most challenging winter on record’, amid an apparent lack of central government support.

Last month, NHS England revealed its £250m GP winter funding plan, which left leaders ‘dismayed’. The plan had been described as ‘arbitrary’ by the Institute for General Practice Management (IGPM), with the BMA’s GP Committee advising practices ‘not to engage’ with it.

And this week the health secretary has been criticised for failing to evidence claims made to a House of Commons committee suggesting that ‘lack of availability of GP appointments has led to increased pressure on emergency departments’.

Meanwhile, this month’s workforce data shows England has lost the equivalent of 1,700 full-time, fully qualified GPs since 2015, the day after Sajid Javid admitted the Government will fail to fulfil its election pledge to recruit 6,000 additional full-time equivalent GPs by 2025.

Workforce model ‘broken’

As part of the report, health leaders want the Government to give ‘greater leadership’ on public health, with stronger messaging needed to help the public manage risk, Chris Hopson, chief executive of NHS Providers said.

Notably, this should include better communication about vaccine uptake, and how transmission is still possible despite being fully jabbed. Mr Hopson singled out the prime minister’s role in communicating these messages more frequently.

Yesterday, the JCVI announced the booster programme would be extended to include over-40s, amid concerns that only a third of eligible adults have come forward.

The underlying causes which have forced the NHS and social care into a ‘completely unsustainable position’ must also be addressed, he said.

This must mean addressing ‘a broken workforce model’, insufficient capacity to match growing demand, inadequate funding and a social care system in crisis – all of which have been exacerbated by Covid-19.

‘The message from trust leaders is loud and clear: judging by the pressure the NHS is currently under, the service is heading for the most difficult winter in its history,’ he said.

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