Campaigner concerns are misplaced, and the NHS needs more integrated services to survive.
Last month, Allyson Pollock warned in an article for the New Statesman that the development of accountable care organisations represents an attack on the fundamental principles of the NHS. Her’s is one of a number of voices arguing that accountable care will result in private companies playing a bigger part in running NHS services and is occurring without proper public and parliamentary debate.
The reality is rather different and more prosaic. The areas of England leading the development of accountable care are doing so in response to the huge pressures on the NHS. Hospitals in particular are struggling to cope with growing numbers of people with complex needs presenting at A&E departments. Senior doctors have stated that patients are dying unnecessarily as staff try to manage ever growing workloads.
The NHS requires more money and staff to avoid a recurrence of this winter’s crisis but it must also redouble efforts to put in place new care models better suited to the population’s changing needs. It is this that lies behind the interest in accountable care rather than a hidden agenda to privatise service provision.
Areas as diverse as Cumbria, Frimley, Nottingham, Northumbria, and Salford are pioneering new forms of “accountable care” in which health and care services work together to provide more services in people’s homes and the community. Early evidence collected by NHS England shows that these areas have started to buck the long term trend of rising demand for hospital care. This holds out hope that new ways of delivering care will deliver benefits for patients and staff.
Why then has accountable care got a bad name? One reason is that the language of accountable care originates in the United States and carries connotations of the excesses and inequities of that country’s health care system. Another is that NHS England has proposed a new contract for accountable care organisations which could be used by NHS commissioners wishing to develop accountable care by testing the market in a competitive procurement.
Campaigners opposed to accountable care have launched two judicial reviews of the proposed contract. Their main concern is that private companies could compete successfully to take on the contract and that this would run counter to the core values of the NHS. The collapse of Carillion has reinforced this concern by illustrating the risks to the public sector …read more
Source:: New Statesman