One of the top clinical officials within NHS England has criticised the new care models programme intended to play a major role in reforming the healthcare system.
GP and NHS England London clinical director of emergency care, Dr Tom Coffey, stated that he is “not a fan” of the new care models and that vanguards and multi-specialty community provider schemes make him “lose the will”.
The opinion of this major figure will be considered particularly significant, as Coffey is responsible for advising London mayor Sadiq Khan on health policy.
Yet by his own admission he is wary about organisational change within the NHS, which by his estimation easily produces two years of paralysis.
Coffey was speaking at the annual conference of Londonwide LMCs.
And the clinical director went on to suggest that politicians are motivated by issues of ego and presentation rather than practicalities when instigating such models.
“Politicians love a legacy. So they come to power and say, what can I do, what can I change? Because they can’t change the relationship with the patient in the consultation room, which is what matters to patients, they think, let’s change the system. So, Andrew Lansley has changed it, Alan Milburn has changed it. Now Simon Stevens is going to try to change it.”
Coffey suggested that integration between GPs and hospitals is of minimal value to patients, with the average person in the street usually more concerned about joined-up services within the local community.
The GP who works in London went on to indicate his belief that practice federations would ultimately be the best solution to the problem.
“The reason I got involved in a federation isn’t because I would have done it if I’d had a blank piece of paper. It’s because I know people want to make us change. I thought, what model can I choose that would give us control with minimal change, which would allow us to direct it so we are integrated with social care, mental health and voluntary sector. I’m not a fan of models, but we cannot pretend that people aren’t trying to create these things, so I would just grab the opportunity and do it that way.”
At the same events, Hurley Group partner and former chair of the Royal College of General Practitioners, Dr Clare Gerada, also expressed concern about care models.
Gerada suggested that many GPs become involved with the new initiative without fully understanding its implications on their everyday practice.
“We are encouraged to [federate] because of economies of scale. Well, there aren’t any economies of scale unless you close practices down. There are very few functions that can be done at the top of the office. Now, it’s this new model has come and everybody jumps. And doesn’t understand the financial implications, the implications for themselves as providers.”