Very interesting article about the vision of the NHS to transform and consolidate our public healthcare system to drive further efficiencies and move even further towards personalised medicine. This approach is not without significant challenges on a number of fronts - not only policy and legal difficulties but the uncertainty and general nervousness about changes in entrenched healthcare models from those providing care at the point of delivery. In my opinion, the best way to drive such change is ensuring the right people are engaged to convey the consolidation vision in all communication through all channels and all levels and networks. Support and training alongside this, setting up the right structural framework to support the new models, and optimising the use of technology, are the best ways to ensure the underlying confidence needed from everyone involved to change attitudes and drive forward this vision.
The NHS is split between those who commission services (NHS England and CCGs) and those who provide services (NHS FTs, GPs etc) and commissioners and providers have separate and often different statutory duties that do not enable true integration in a legal sense. Nonetheless some systems are trying to work together under a shared governance arrangement which is not legally binding and is based on a high degree of trust and an understanding that they will be mutually accountable for each other’s actions.