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ICBs asked to ‘referee’ workload-dump situations between primary and secondary care

NHS England has asked integrated care boards (ICBs) to act as ‘referees’ to resolve ‘tension’ between primary and secondary care around workload and referrals.

NHS England‘s deputy medical director Dr Kiren Collison said there is ‘a lot of tension at times between primary and secondary care’ and that NHSE is ‘trying to get away from that’.

Speaking at the recent NHS Confederation Expo in Manchester, the Oxfordshire GP said NHS England has asked ICBs ‘to be a mediator’ as part of a ‘system approach’.

Dr Collison said: ‘We’ve seen a lot of tension at times between primary and secondary care. Primary care saying: “why are you dumping work on me” and secondary care “why are you not giving me the information that we need” or “this is a rubbish referral” – we get that all the time. And it comes from both sides. We’re trying to get away from that.

‘And that’s why we’ve asked ICBs to always be that facilitator, that mediator – a referee, if you like – to come in and say: these are the people we need to come to the table.

‘We need primary care, we need [local medical committees] LMCs and secondary care, and if it’s the right setting, community services and others.

‘They are the mediators of this, because actually, this is a system approach. This isn’t just about: secondary care you do this, primary care you that, it is about what do we all need to do in the interest of the patient, for that pathway and how do we all come together to do that?

‘So I would say your ICB has that role to be that referee.’

Last month, Hospital Healthcare Europe’s sister title Pulse exclusively revealed that GP leaders feared that NHS England is planning to replace the traditional system of direct GP referrals, with ICBs now being encouraged to take up an enhanced form of advice and guidance.

According to the BMA, NHS England is hoping to roll this system out on a national level, but the GP Committee for England said this risked adding barriers for patients to access secondary care.

In April, NHS England’s 2024/25 priorities and operational planning guidance stated that every hospital trust will be required to have ‘a designated lead for the primary-secondary care interface’ and ICBs asked to ‘regularly review progress’.

A version of this article was originally published by our sister publication Pulse.