This afternoon we got the answer to one of our questions straight from the horse’s mouth on national radio. Secretary of State for Health Andrew Lansley answered on Radio 4’s PM phone in about the new NHS reforms the question we and others have been posing about how the more complex, often degenerative, neurological conditions will be handled in the new GP consortia commissioning arrangements.
Our concern is that with the momentum leading to shut down of Primary Care Trusts, the needs of people with long term neurological conditions (LTNC) would get lost – not because they are few in number, because their conditions were clinically complex and often not familiar to GPs. For example, the average GP may only see 1 or 2 people with motor neurone disease in a lifetime of practice.
With the creation of hundreds of new consortia, the danger is that the new web-based commissioning tools which MAC assisted Neurological Commissioning Support (NCS) to create would not get used and the lives of people with LTNC would deteriorate because of inadequate and uncoordinated services in health and social care.
Mr Lansley said he understood this issue. He told Radio 4’s PM audience that improving health outcomes for patients with complex needs was a priority in the new Health and Social Care Bill and would be delivered through the duty on the NHS and Local Authorities to work closely together and to integrate services. He gave end of life care and palliative care as specific examples.
Mr Lansley has visited the MND care centre in Cambridge and spoken to people with MND about their needs. Full marks for that. He said that PCT-level commissioning of services for MND had not worked very well to deliver improvements in quality. His view was that if the new GP-led commissioning consortia were sufficiently large – he understood that the prevalence of MND was about 7 per 100,000, so he was well briefed – then they might commission for this group or – more likely – they could form a broader network for that purpose. So collaboration in commissioning is the answer.
We already have cancer networks, but neurological networks are thin on the ground. This is the opportunity to expand them. He stressed that the new arrangements would encourage collaborative commissioning for complex and rarer conditions.
This is also an opportunity for the neurological 3rd sector bodies to step forward. Mr Lansley, as he has previously, again singled out the Neurological Commissioning Support service – a joint initiative of the MND Association, Parkinson’s UK and the Multiple Sclerosis Society – and a former MAC client – for praise.
Publicity like that can’t be bought and we hope our friends in the LTNC community can use this as powerful leverage with the new commissioners. We wish them well.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.