A business critical briefing from HSJ’s Fundamentals of the NHS conference.

Key themes

  • Overview of the latest changes in NHS structure, policy and reform for NHS colleagues, partner and suppliers
  • The effect of the introduction of revalidation on patient care 
  • How a GP consortium might take shape based on current practice based commissioning structures, working together with PCTs
  • The shifting onus for providers to focus on outcome based care that centres around patient safety
  • Legal considerations for commissioners and providers

Action points

  • Remain on top of policy changes anticipated over 2011.
  • Ensure the implications of revalidation for medics are well understood within local organisations.
  • Focus on the changes that can be delivered as the unknown cannot be tackled.
  • Encourage staff to incorporate the use of a skills passport.

 Key questions and answers

Q All trusts must become foundation trusts. Is there likely to be downsizing or closures?

  • Amalgamating trusts would ensure hospitals could use beds more efficiently. There is an onus on all types of provider to operate more efficiently. Efficient management of chronic conditions will help to ensure efficiencies are realised. The focus should be on safe and effective care.

Q What is the role of the GMC in training and supporting GP commissioners?

  • The GMC is a regulator and not a trainer. We will require GP commissioners to perform to the standards set for all other doctors. However, GPs will not be in breach of the revalidation process if they choose not to provide a particular service in the light of GP commissioning.

Q How can providers work together in the future?

  • Clinicians in both primary and secondary care need to get together to work through specific scenarios so solutions can be reached. Clinicians will revert to what is best for patients and not who can earn the most.

Q What is the optimum size of consortia?

  • Some of the biggest consortia do not have all practices equally engaged. Smaller, specialist consortia might be better placed. If managing the system is harder than delivering care, there must be something wrong with the system.

Sarada Chunduri-Shoesmith is risk manager at Hillingdon Community Health.

Fundamentals of the NHS