NHS England has ‘no primary care strategy or expansion plan’ and pockets of short-term investment in the sector have ‘failed’, the government has been warned.
Primary care representatives – including those within dentistry, pharmacy, general practice, optometry and audiology – have issued a damning response to the government’s 10-Year Health Plan consultation.
In a joint submission, Community Pharmacy England (CPE), the British Dental Association (BDA), the British Medical Association (BMA), the Optometric Fees Negotiating Committee and the Association for Primary Care Audiology Providers called for primary care to be put ‘at the heart’ of the new plan.
They said that their ability to be ‘the backbone of the NHS’ had been ‘been severely impacted by the many years of funding cuts and wider pressures’.
And they warned: ‘NHS England has no primary care strategy or expansion plan. Short-term “recovery plans” and non-strategic bursts of short-term investment have failed.’
Meanwhile, ‘NHS restructuring has regularly focused on secondary care, neglecting primary care’, the bodies said.
‘This has caused a vicious circle: missing opportunities to keep people well and out of hospital, placing more demands on hospitals, driving NHS costs, which further deprive primary care of resource, meaning yet more missed opportunities to prevent ill-health and reduce demand,’ they added.
To reverse these issues, funding must be shifted from secondary care to primary care, the bodies said.
And they highlighted that Lord Darzi’s recommendation of ‘a neighbourhood NHS’ was already being provided through ‘6,300 GP practices, 6,500 dental practices providing NHS dentistry, 10,450 community pharmacies, 6,000 high street opticians, [and] 1,500 primary care audiology centres’.
They stressed that the government should avoid further restructuring and build on existing structures to repair the NHS.
‘This is an immediate policy position that government and the NHS can take. Across primary care we have a network of neighbourhood healthcare centres, with the skills and ability to go further for patients: we should be supporting and investing in this existing network,’ the joint submission said.
But while the health professionals employed in these community care settings ‘work closely together where possible’, the primary care representatives said that ‘their ability to do so is often hampered by inadequate systems, poor data sharing, and competing financial incentives’.
‘We therefore wholeheartedly agreed with Lord Darzi’s recommendation that we need to develop multi-disciplinary models of care, to allow our members to work together more seamlessly and to foster and reward true collaboration across systems for patients and population,’ the bodies added.
A clear plan for primary care should be set out and linked to investment, with any underspent budgets returned to the primary care services for which they were allocated, they said.
In addition, primary care should be given an equal voice and representation in integrated care board (ICB) and NHS England planning, the submission said.
