NHS East of England is considering proposals to launch a series of pilots across the region that would see complete patient pathways on the National Health Service put out for tender.

Following a report in Pulse Magazine last week, a spokeswoman for the strategic health authority has confirmed that primary care trusts will be approached later this month about road testing 'integrating pathway hubs' (IPH), which it defines as a healthcare organisation commissioned to be accountable for the quality and cost of the entire patient pathway, while providing care in the centre of the pathway itself.

It is envisaged that such hubs will help to support the delivery of quality primary and community care, by providing multidisciplinary specialist health services and referring/subcontracting patients on to more specialist care - such as acute trusts, voluntary and independent sector providers - where necessary.

According to the Strategic Projects team at NHS EoE, the concept of an IPH is "an exciting one and opens up creative approaches to meeting patients’ health care needs in their own communities". 

Explaining the need for change, it argues that complex contracting arrangements with multiple providers of healthcare services has left some patients frustrated with disjointed and uncoordinated care, while commissioners have struggled to manage a sharp rise in demand within stagnant resources. 

A new type of provider that is able to manage a patient ‘pathway’ across primary, community and acute care is needed to address these issues, and "IPHs could be a key part of that solution", it says.

£603 million saved?

Moreover, according to early feasibility research implementing these changes could slash costs within the NHS nationally by £603 million per year, an attractive proposition for the health service given that it has been tasked with garnering efficiency savings of up to £20 billion by 2014.

Under the plans, various providers of care - such as GPs, specialists, foundation trusts, independent and those from the voluntary sector - could participate in IPHs in a number of roles, including employees, contractors, shareholders, or owners, both singularly or as part of joint ventures. 

However, the proposals generate immediate questions over a potential for conflict of interest (as presumably GPs could bid for contracts as well as provide services), as well as those of a more structural nature - who will put together the pathways, what will happen following the demise of SHA's, and what about patients with potentially linked conditions, for example.

But the spokeswoman noted that, as IPH pilots are still in the proposal stages, operational detail about how the hubs will work in practice is still being established.  

No plans for national launch

A Department of Health spokesperson told PharmaTimes UK News that "it is important, locally and regionally, that the NHS identifies and makes the case for proposals that will improve outcomes for patients and the efficiency of the services they provide". 

In addition, it was stressed that there are currently no plans for a national rollout, but that the DH "will be interested to see and learn from the East of England's pilot."

NHS East of England is planning on lining up the relevant partners in commissioning IPHs this month, with a view to launching services early next year.