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While the 5YFV (Five Year Forward View) was published back in October, it’s really only been a few weeks since the NHS in England actually knew where it stood.
The outcome of the general election in May provided the confirmation needed: the new Government would support this direction of travel (as indicated in the Conservative Party manifesto and a post-election speech by David Cameron).
So, in early June, NHS England and six partner organisations published Time to Deliver — a stocktake and next steps-type document for implementation of the 5YFV.
We recently surveyed BMA members on the 5YFV. Nearly twice as many doctors are unfamiliar with it as are familiar (63 per cent v 32 per cent).
The same goes for one of the new care models — the MCP (multi-specialty community providers). Although they were more familiar with another of the models — the PACS (primary and acute care systems) (55 per cent).
Familiarity with implementation of the new care models (the ‘vanguard’ sites) was the lowest — 70 per cent of respondents were not at all familiar with it.
Can this be explained by the hiatus between publication of the 5YFV and the general election? Probably not. It’s more likely to be down to ‘new policy leads to yet more change’ fatigue, plus the mounting pressures of the day job (more patients, more complexity, less time, less money…).
It goes without saying that, without doctors and other clinicians on board, the transformation of the NHS into a more coordinated and integrated health system, as envisaged by the 5YFV, is unlikely to be achieved.
We asked hospital doctors how interested they would be to learn more about local GP practices’ plans to provide more specialist services in the community/primary care setting (MCPs in their crudest sense). Nearly half would be interested or very interested to learn more. That’s not bad.
And GPs? We asked them how interested they would be in learning more about their local hospitals' plans to open or run GP practices (PACS in their crudest sense). Just over a third said they would be. Not quite as good.
But more and most importantly our survey provides an insight into how to capture the attention of doctors as the new models start to emerge across the country.
There are three main things hospital doctors want to know (in this order):
– Whether GP practices’ (or MCPs’) proposals are clinically sound and supported by evidence
– Whether they will result in more patient-centred and coordinated care
– Which services GP practices/MCPs plan to provide.
And there are three main things GPs want to know (in this order):
– Whether local hospitals’ (or PACS’) proposals will affect their GP practice
– Who will provide the GP service (ie skill mix).
Now note the overlap. All doctors care about the health service being more patient-centred and coordinated. And with the potential for MCPs and PACs to prove divisive for the profession (the perception being that each one is led by a particular sector, rather than genuine cross-sector collaboration), this overlap is something to pin hopes on.
While much more ground work is needed before doctors know what NHS England thinks it’s ‘time to deliver’, our survey indicates that doctors already know what they want to deliver. The question is how.
Read more about the 5YFV in new BMA briefings.
Sally Al-Zaidy is a senior policy analyst in the BMA health policy and economic research unit