Primary care is coming home

20 November 2015
Good ideas have a habit of sinking without trace, but from time to time they bob back to the surface long after the search has been called off.
The NHS way of dealing with these returnees is usually to give them a new identity and introduce them with tautological pomp as a “new innovation”.
In the case of the “primary care home”, championed by Simon Stevens in a speech at a National Association of Primary Care conference in October, there was no attempt at rebranding. The idea came back looking very like the version that left its clothes on the beach before the reforms.
The primary care home sees groups of health professionals working together with control of its own budget set according to the size of the population. It is very similar to the multispecialty community provider (MCP) model of the Five Year Forward View but with a more user-friendly name, chosen to appeal unapologetically to those who see primary care as the locus of healthcare.
So if the primary care home is just another term for MCP, why do we need it? Fans of new models will be disappointed by its lack of novelty, but with the backing of the National Association of Primary Care – and the implicit endorsement of Simon Stevens – the primary care home is a branded version of a “new model” that professionals may feel more comfortable supporting.
While the officially sanctioned models are carefully neutral, designed to appeal to all tribes, the primary care home can afford to be more partisan - as long as it also remains inclusive.
Despite its homely feel, the concept smuggles in some hard truths about the way the NHS buys and delivers services. When you give capitated budgets to middle sized primary care providers, you also change the nature of commissioning. It becomes a strategic function that requires a significant transfer of responsibilities currently thought of as commissioners’ business to providers.

Some will say that the resurgence of the primary care home is just another example of the NHS’s seemingly endless capacity for repeating history. A more optimistic view is that we choose to study recent history the better to learn from it.



Resources Briefings

Latest News

Make your primary care network work for you

20 March 2019

Spring is a busy time for practices.

This year, as well as the annual delights of year-end reporting, QOF, DSP and the day job, practice managers have been told to get on with forming primary care networks (PCNs).

“Told” because “working at scale” is no longer just a helpful suggestion but a matter of policy. Participation of individual practices is officially optional, but as there are going to be financial incentives for working in networks – and diminishing prospects for those who chose to rely on the core contract – the element of choice is more limited than it may appear.

Read More

The state of ageing in 2019

19 March 2019

A report from an older people’s charity brings together public data about work and finances, housing, health and communities. It reveals big differences in how people experience ageing depending on factors such as where they live, how much money they have or their sex or ethnicity. Today’s least well-off over 50s face far greater challenges than their wealthier peers and are more likely to die younger, become sicker earlier and fall out of work due to ill health.

Read More

Better transition for young people in inpatient mental health settings

19 March 2019

NICE and the Social Care Institute for Excellence have published a guide to help practitioners prepare for a planned admission and or discharge from inpatient mental health services. It covers planning for admission, preparing for discharge, care and support after discharge, crisis planning, and information and support for parents and carers.

Read More

New academic prize for general practice nursing students

19 March 2019

The Queen’s Nursing Institute (QNI) has launched a new academic prize for students of specialist nursing programmes in England, Wales and Northern Ireland.

The Ellen Mary Memorial Prize is available for students of the specialist practice qualification in general practice nursing. The prize is available at every university that offers the NMC-approved course.

Each university is invited to nominate the student in each academic year who has demonstrated the most outstanding achievement during the period of study. The criteria to assess the student’s outstanding achievement are determined by the university faculty.

Read More

Medical director’s report of access standards

18 March 2019

In 2018 Professor Stephen Powis, NHS National Medical Director, was asked to carry out a clinical review of standards across the NHS, with the aim of determining whether patients would be well served by updating and supplementing some of the older targets currently in use. In this interim report, Professor Powis sets out his recommendations.

Read More