NHS England chief defines 'multispecialty community providers'

Simon Stevens, speaking at the first annual HSJ lecture last night, emphasised there were currently no arrangements that met the conditions of an MCP.

He said it was a group of GP practices that come together with nurses, hospital specialists, community services, pharmacists and in some instances mental health and social care to create integrated out of hospital care.

Mr Stevens said: “This is not just a federation of GP practices and it’s not just a relabelled care trust.”

He set out nine requirements for an MCP. These included a need to blend primary medical services with some specialists in a single organisation, and an expanded multidisciplinary team that includes pharmacists and nurse leaders.

They would also have to do in-reach work in other care settings, for example care homes, and could take on responsibility for managing some acute medical patients of a district general hospital.

MCPs also needed to develop “sophisticated risk stratification” and divide their patient list into segments to identify the top 5 or 6 per cent of patients with the most complex conditions. They required integration with NHS 111, primary care extended access and a “clear set of metrics” to measure performance, he said.

They must have a minimum population size of 50,000, Mr Stevens added.

The NHS England chief executive said MCPs would see the organisation’s urgent and emergency care strategy - which has been interitatively developed over the past year - “come to fruition straight away”. This review sets out future configurations for emergency departments, including a GP led service.

MCP providers could optionally decide to take on responsibility for a delegated population budget and could take control of some community hospital services, but not acute hospital services.

Mr Stevens emphasised the importance of making the most of pharmacists.

He said: “There is something paradoxical that we have a surfeit of pharmacists as a result of the number of pharmacists coming through training and yet we also have a surfeit of strategies down the years describing how ‘If only we could get pharmacies more involved in primary care that would be a win-win for everybody’.”