The NAO comments that in the fourth wave of LIFT, LIFTCos will be encouraged to "expand the range of services provided" (page 32, para 3.16). What the NAO is referring to here is the delivery, through the private sector, of clinical primary care services.
In a document from Partnerships for Health that was circulated to private sector bidders, healthcare companies and their advisers described how clinical services will be delivered through LIFT under the alternative provider medical services route.
The clinical services which may be included in LIFT's fourth wave are as follows:
1. Essential Medical Services: including care for those who are ill, or believe themselves to be ill, but recovery is expected.
2. Replacement Additional Services: These services include Cervical Screening, Contraceptive Services, Vaccinations and Immunisations-excluding childhood immunisations and certain travel vaccinations, Childhood Vaccinations and Immunisations, Child Health Surveillance Services, Maternity Medical Services and Minor Surgery.
3. Enhanced Services: These include Intrapartum Care, IUCD Fitting, More Specialised Services for patients with Multiple Sclerosis, More Specialised Sexual Health Services, Alcohol and Drug Misuse Services, Provision of Near-patient Testing-shared care drug monitoring service, Provision if Intermediate Care and First Response Care, Specialised Care of Patients with Depression, Care of the Homeless and Anticoagulation Services.
4. Out-of-Hours Services
5. A combination of any of the above
This proposal will dramatically reduce the public sector role in primary care services.
18 October 2005