Contracting arrangements for Integrated Care Providers – consultation response

We responded to NHS England in 2018 welcoming a contract that provides a more seamless and holistic framework in which to bring together primary care, hospital and community services and health services being delivered in partnership with local authorities.

NHS England issued a draft contract to provide detail about how the Integrated Care provider Contract would underpin integration between services, how it differs from existing NHS contracts, how it fits within the broader commissioning system and which organisations could hold the contract. 

Our response

  • There is no mention of children in the draft contracts and the incentives appear to be adult focused.
  • It is not clear how nationally commissioned services (such as neonatal care) will function within this new proposal given it is inextricably linked with maternity services.
  • There is a risk that each lead provider will focus on their organisations priorities, rather than that of the local area.

Our recommendations

  • Commissioners must enhance their knowledge of child health and wellbeing and demonstrate leadership in their respective commissioning roles so that the needs of children are met for the populations they serve.
  • The RCPCH expects that integrated models of care, and therefore the commissioning arrangements designed to support these models, should address the wider determinants of health and tackle inequalities.
  • A pilot study will help to identify issues clearly and a pilot for remote and rural or smaller services would be of great benefit to those populations.

NHS England and NHS Improvement published their recommendations to the Government in September 2019 regarding an NHS Bill, following the consultation. These recommendations do not mention children and young people specifically, but do refer to a 'triple aim' for commissioners and providers that encompasses the whole population and all patients. The NHS's recommendations to Government are available via the link below.


We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: health.policy@rcpch.ac.uk.