Next steps for integrating primary care - a stocktake of out of hospital services

A report into what is working well in integrated primary care and how it can be progressed across systems has been published by NHS England.

30 May 2022 - 10:28AM

The Fuller Stocktake report sets out a series of findings and recommendations that echo much of what the CSP have been discussing and working on for a long time.

Among its recommendations for action are that:

Integrated care systems must support primary care networks to evolve into integrated neighbourhood teams that work with community staff on admission avoidance, discharge and flow as well as targeted interventions to reduce health inequity.
ICSs and PCNs should work in partnership to put in place infrastructure to support primary care with data, digital, human resources, workforce plans and buildings.
The government should work with NHSE and HEE to include primary care as a priority in a future national workforce strategy, including looking at how the Additional Roles Reimbursement Scheme (ARRS) should operate after March 2024 and how this could be made more flexible.

Among the observations is the need for there to be a sense of shared ownership of services between different professions. The CSP welcomes this vision but are calling for there to be more emphasis on the wider workforce and all the different roles that make up primary care and community services, not just GPs and their immediate teams.

CSP policy director Rob Yeldham said: ‘Physiotherapists are at the heart of primary care and community teams and have key roles in prevention and rehabilitation, improving population health and providing personalised care to patients.

It is great to see the example of best practice in the report, the Foundry Health Centre in Lewes, includes a first contact physio in the team.

‘If we are to take the next steps to build integrated neighbourhood teams then all relevant professions need to be equal partners in developing them.’

The report recognises that community teams can only operate at their most effective – and address the profound health inequities that exist in all parts of the country - when they have access to timely, relevant and accurate population data.

This is echoed in much of the work the CSP are engaged in with the Community Rehabilitation Alliance, whose data task and finish group has set out to map the data needs or services in order to provide the best care possible to patients.

Flexibility on ARRS, too, is something that the CSP continues to advocate for. Using this to fund other physiotherapist and ACP rehab roles, in addition to MSK first contact physios, would help secure the wider ambition of cohesive, integrated community teams.

Building these neighbourhood teams will only be possible if there are people to be part of them. That’s why, alongside this stocktake report, the CSP are calling for a review of community rehabilitation provision which is core to the wrap around neighbourhood services that the report refers to. This must be made a priority for workforce planning as these services are instrumental in supporting discharge, preventing emergency admissions, and in anticipating the care needs of people with chronic conditions.