Health authority view of a primary care-led NHS

Abstract

A primary care-led NHS is not simply a blueprint for a new delivery system, it is an elastic term applied to many different visions of future service delivery. Health authorities face a number of challenges – they must define their role and delegate their direct contracting role to others, while focusing on strategic commissioning/coherent strategic planning. The temptation to delegate wholly the task of clinical prioritisation to primary health care teams should be resisted, because health authorities must articulate public views and values as part of the clinical decision making process. With purchasing decisions increasingly made at primary care level, this will most likely result in an unintended/unrecognised impact on local health services development. However, the growth of locality commissioning groups of general practitioners (GPs) invites local planning and the development of quality assurance and improvement systems. With locality structures identifying the variability between primary health care teams, health authorities are well placed to facilitate a dialogue between primary care teams and between primary and seconday care clinicians.