This paper focuses on the structural barriers to delivering integrated care. It studies issues such as the medical labour market, devolved workforce planning and pay, and professional boundaries | Reform
The Government is rightly committed to a radical reshaping of NHS delivery, based on a shift to new care models and treatment in the community. Its management of the NHS workforce, however, has not delivered with nearly three times more doctors, and four times more nurses in the acute sector than in the community. Since 2009, the number of consultants has risen by nearly a third, whilst the number of GPs has fallen.
Freedom of Information requests made for this report found that, across 61 acute trusts, only 6 per cent of consultants work in the community for at least one session per week.
As the Government and the NHS leadership have repeatedly said, the priority for the NHS is to increase its speed of innovation. To do this, the NHS is rightly seeking to devolve decision-making and to deregulate. For the workforce, however, policy remains highly centralised and tightly regulated. This paper shows how to bring the same reform ideas to the workforce as the NHS is applying to other areas.