Integrated care boards: Government urged to ensure wider primary care representation

Optical membership bodies have joined with representatives from professions across primary care to call on the Government to ensure wider primary care services “have a voice” in planned new NHS systems, as the Health and Care Bill enters its Second Reading in Parliament.

Introduced to Parliament last week (6 July), the Health and Care Bill aims to provide a legal basis for planned reforms to the NHS in England. This would see responsibility for managing contracts for primary NHS services shift to Integrated Care Boards (ICBs).

Currently, the bill requires ICBs have a number of ‘ordinary members’ including representatives from local NHS trusts, local authorities and a member nominated by general practice.

Professional bodies including the Association of Optometrists (AOP), the Association of British Dispensing Opticians (ABDO) and the Federation of (Ophthalmic and Dispensing) Opticians (FODO), have joined with the Pharmaceutical Services Negotiating Committee (PSNC), the British Dental Association (BDA) and the National Community Hearing Association (NCHA) to raise concerns that the current requirements for ICBs leave no space for insight from primary care professions beyond general practice.

The membership organisations have warned that the current draft legislation “risks leaving around 190,000 non-medical primary care professionals working in the NHS in England shut out of representation on the boards,” adding that this is despite GPs “accounting for only about a third of the primary care workforce in England.”

As the bill progresses through Parliament, the organisations are calling for an amendment which would include an extra member nominated by clinicians providing non-medical NHS primary care services in the area covered by the ICB, such as optical professionals, community pharmacists and dentists.

In a joint-statement, the AOP, ABDO, FODO and the NCHA, said: “Optical practices and other primary care providers are vital to population health and care, and need a voice at all levels of the NHS in England.

“That’s why we are working together and calling on MPs to include provisions in the Bill to make sure this happens starting with the new Integrated Care Boards.”

The calls for change would see the list of ‘ordinary members’ of ICBs in Schedule 2 (p127) of the bill amended.

BDA chair, Eddie Crouch, commented: “Voices that make up three quarters of NHS primary care risk being lost in commissioning decisions that affect their services and the millions of patients they treat and serve every day. General practice simply cannot be expected to effectively represent the views, perspectives and distinct challenges facing colleagues in the wider NHS.”

He added that the professional bodies believe “for the benefit of patients and the NHS,” the contribution of non-medical primary care professionals must be recognised at every level, including ICBs, adding: “The only way this can happen effectively is if colleagues are guaranteed a seat at the table. That means a board presence drawn from non-medical primary care professions such as dentists, community pharmacists or optical professionals.”