Report comment

What if the local GPs want to run one of the two new types of neighbourhood contracts? Say the biggest one?

How will it fit? Will it be a carve out of the IHOs capitated contract? How will the scope and amount of the carve out be agreed, or will it in that regard be like the Dudley MCP row with Dudley FT?

Will it have a similar right to become one like a FT seems to be promised here?

What if the ICB doesn’t want its FT to become an IHO?

Can it say no, or in what sense is it a strategic commissioner?

Will it really be able to have a new currency based model for the IHO as opposed to existing baselines put together as pragmatically developed in the original ICP contract developed in 2016/17? New currencies imply winners effects which are an affordability challenge

How does any of this fit with plurality? Saying ICBs will be free to increase plurality is incredibly weak - they won’t behaviourally do that. Either there are new entry rights that remove local veto or choice will go backwards ( for better or worse)

Lots to be worked through to avoid it being incoherent and impractical. Separate from the question of whether if coherent and practical, it actually works.