Your essential round up of the must read stories and debate in the NHS

The name rings a bell

“They could call it a primary care trust” was the reaction of a number of readers to news that new NHS organisations – potentially taking a new form – may be created to house the NHS’s first “accountable care organisations”.

Combining a commissioning budget with prevention, provision of community services (and in the case of some old style care trusts, social care) and close relationships with general practice was indeed close to the original intention of PCTs (and wouldn’t going back to that be better than the current mess?)

What PCTs did not achieve though, most observers would agree, was breaking down the wall between general practice and the rest of the NHS. The Five Year Forward View (remember that) described a “future that dissolves the classic divide, set almost in stone since 1948, between family doctors and hospitals”.

Only a small number of areas are perhaps now getting close to defeating of this divide organisationally – and some of those are the ones that may benefit from the creation of new NHS organisations equipped for the role and trusted enough for sufficient GP practices to move properly into the NHS family at last.

Creating new trusts or foundation trusts will likely only be justified if this can be achieved – so there is a simplification and integration of numerous independent practices into a coherent whole, rather than just yet another organisation to fit into the organogram.

People are rightly tired of structural change but it’s part of a reshaping of the NHS landscape that might, unfortunately, be needed.

Winter gloom and glad tidings

There were more discouraging A&E figures released on Thursday, but HSJ has an early Christmas present for those looking for solutions.

Let HSJ editor Alastair McLellan explain:

“We report exclusively on the initial findings of the centrally funded Improving Access to Psychological Therapies programme, which brings mental health support to those with long term conditions. Analysis from the first cohort of patients to benefit to from the services is potentially a game changer.

“The most robust findings, from Cambridgeshire and Peterborough Clinical Commissioning Group, show a 61 per reduction in accident and emergency attendance in the cohort of patients accessing the integrated IATP services – 61 per cent. Just let that sink in.

“The impact on GP visits (down 73 per cent) and inpatient admissions (down 75 per cent) was even greater.

“If this was not reason enough for the NHS to find every way it can to invest in mental health there is also growing evidence that poor mental health is an even bigger driver of cost to the NHS than age or chronic disease.

“It is an argument that should convince even those whose focus is on the service’s bottom line.”