As many as 68% of CCG leaders believe that Integrated Care Systems (ICSs) will be more likely to focus on secondary care than on primary care, Healthcare Leader can reveal.
The survey of more than 140 CCG leaders and staff members indicated that a further two-fifths (42%) feel that ICSs will not support primary care.
The report – CCGs: A post-mortem – comes a week after a integrated care boards (ICBs) gained statutory footing and formally replaced CCGs as the NHS’ commissioning bodies.
ICBs – which are responsible for allocating funding from NHS England – are required to have at least one primary care and one trust representative on their board.
However, a Healthcare Leader investigation revealed that there will be significantly more space for secondary care leaders at board level than for primary care.
Dr Agnelo Fernandes, CCG borough lead for Croydon, said: ‘The bulk of the finance of the NHS is spent in hospitals, so any deficits in the system will go to the biggest mouth, and that’s going to be the hospitals.’
The NHS has returned working on a ‘reactive’ basis, he suggested, noting that ‘the magic money tree of Covid is going to stop and hospitals are going to have to be more efficient’ in how they work.
‘Unfortunately, without the input of CCGs or commissioners or anything like that, it’s going to be insular again within the hospital. The financial challenge is going to be even greater going forward, meaning primary care will have less resource and have less influence,’ he said.
Others were concerned that the lurch to acute trusts would stifle primary care organisations’ ability to meet its population’s health needs.
Dr Neel Gupta, the governing body member and finance committee chair for North Central
London CCG until 2020, said: ‘My worry is you’re just going to end up with a new commissioner and an ICB with new people, but still have a provider-commissioner split with the ICB commissioning the providers.
‘In terms of how we spend our money, that would still be very heavily weighted towards reactive acute care and our outcomes will go nowhere, if not get worse.’
Last week, MPs launched a new inquiry into Integrated Care Systems (ICSs), days after their official launch.