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ICSs won’t ‘magic up’ a solution to workforce crisis, top GP says

by Jess Hacker
15 September 2021

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Integrated care systems (ICS) will not help solve the current GP shortage, a top GP has said, despite first being touted as ‘central’ to delivering the NHS Long Term Plan.

Speaking yesterday at Management In Practice London (14 September), Dr Farzana Hussain, a GP partner in northeast London and clinical director for Newham Central 1 PCN, estimated that a prospective solution to the primary care workforce crisis is still several years away.

GP turnover has been in steady decline over the last decade, with a recent study indicating that the proportion of practices with high turnover ‘almost doubled from 14% in 2009, to 27% in 2019’.

When asked by an audience member if ICSs – which were introduced as part of the NHS Long Term Plan and would be mandated by Health and Care Bill, if passed – would help with the crisis, Dr Hussain said: ‘Honestly, I think no. I think it might help with some of the modelling, but I’m not sure it will help [solve the problem].’

In its 2019 Long Term Plan, NHSE set out that ICSs would be ‘central’ to delivering on its aims, which included a number of a number of specific workforce actions and wider reforms to address the shortages. The Health and Care Bill would solidify their role by scrapping CCGs altogether.

However, Dr Hussain said that these systems are ‘essentially there to develop strategic direction’ and that, while they may have a workforce plan, they cannot ‘magic up a workforce’.

She said the Additional Roles Reimbursement Scheme (ARRS) is better suited to closing the staffing gap, however, at a protracted rate.

‘We’ve already been given 26,000 additional roles in PCNs, and I think that will help with the workforce crisis. I think the only difficulty is they’re just too new,’ she said.

‘In five or six years, we’ll definitely reap the benefits of that, but it will take four or five years. I’m not sure the ICS will help that.’

In 2019, NHS England launched its ARRS to move 26,000 additional staff into general practice by 2024, as part of the introduction of PCNs.

However, the scheme has since been criticised for lacking the flexibility needed for practices to fully take advantage of the roles and manage waiting lists.

In July, Health Education England (HEE) was commissioned to review the long-term workforce strategy for health and social care sector, building on the NHS People Plan, and renewing and updating the existing long term strategic framework.

NHSE has been contacted for comment.