The Health and Social Care Committee has published a new report on Integrated Care Systems (ICSs), calling for the Government and NHS England to address key concerns if an opportunity to deliver real change is to be achieved [1].
The Committee found that there has been a lot of optimism surrounding the 42 new statutory Integrated Care Systems that came into force in July 2022. These systems are partnerships of organisations that are intended to offer a refreshed way of working across health, social care, wider local authority functions as well as voluntary, community and social enterprise organisations.
The Committee’s inquiry found real enthusiasm for the potential of ICSs to deliver on challenges facing the health and care sectors and that they encourage collaboration with a range of partners and a focus on what matters to local populations [2].
However, the Committee stated it shared concerns regarding the lack of clarity concerning ICSs, particularly in relation to the balance between accountability and autonomy of these systems. They stated the fundamental premise of ICSs needs to be balanced within a national service, funded by taxpayers and accountable to Parliament.
Concerns from MPs
Improved outcomes in population health and healthcare are a central purpose of ICSs. However, the Report notes that public health professions are not required to sit on Integrated Care Boards, one element of the partnership. MPs voiced concern that without this expertise, longer-term priorities will not be addressed and the changes will see a continuation of a ‘sickness service’ rather than produce a health service fit for the future [3].
MPs warn of a serious lack of clarity in some areas with risks that acute short-term pressures could be given priority over longer term ambitions such as preventing ill-health. They also expressed concern that although the Care Quality Commission (CQC) will assume legal powers to assess ICSs from April 2023, the Government has failed to clarify key aspects such as whether ratings are required and the priorities that an assessment would be based on.
Evidence given to the Committee also raised concern about the exclusion of adult social care in new systems and the risk of ICSs becoming ‘NHS-centric’ [4].
Recommendations from the Report
The Report made 30 recommendations: 14 to improve autonomy and 16 to improve accountability.
Key recommendations to the Government and NHS England include:
- Targets for ICSs set by DHSC and NHS England should be based on outcomes, greater prescription around how targets are achieved should be done sparingly.
- Any update to NHS England’s Long-Term Plan must put prevention and long-term transformation at its heart.
- Integrated Care Boards should ensure they include a public health representative, such as a public health director or public health lead.
- DHSC should gather information relating to the membership of ICBs and then review to understand whether further mandating is required.
- DHSC, working with ICSs, should set out action that could be taken to resolve issues of poor partnership working, especially with social care.
- DHSC should urgently provide the CQC with its decision on ratings and any priorities it would like the CQC to focus on.
Chair’s comments
Chair of the Health and Social Care Committee, Steve Brine MP said:
‘This is a key moment for Ministers and for NHS England. We have found genuine enthusiasm for the potential of Integrated Care Systems to make a real change, not only in how health and social care is delivered but in prioritising the needs of local populations and preventing ill-health.
‘It would be an opportunity lost if that success was undermined by the need to prioritise central government targets or a focus on meeting short-term demands.’ [5]
Stakeholder’s comments
Sarah Walter, Director of the NHS Confederation’s ICS Network, said:
‘We would agree with the Committee’s position that long-term improvements to care and health outcomes for communities will be dependent on ICS having the capacity to focus on public health, prevention and their role in the local economy.’ [6]
Next Steps
The Government has two months to respond to this report.
BREVIA HEALTH PROVIDES STRAIGHTFOWARD POLITICAL AND COMMUNICATIONS SUPPORT TO ORGANISATIONS OPERATING IN THE HIGHLY REGULATED UK HEALTHCARE SECTOR
Discover how Brevia can help you and your organisation by contacting the Brevia Team on 020 7091 1650 or emailing us at contact@brevia.co.uk
Notes
[1] Health and Social Care Committee, Urgent action needed to ensure opportunities of new health care restructure are realised, warn MPs, 30 March 2023, link
[2] Health and Social Care Committee, Integrated Care Systems: autonomy and accountability, 30 March 2023, link
[3] Health and Social Care Committee, Integrated Care Systems: autonomy and accountability, 30 March 2023, link
[4] Health and Social Care Committee, Integrated Care Systems: autonomy and accountability, 30 March 2023, link
[5] Health and Social Care Committee, Urgent action needed to ensure opportunities of new health care restructure are realised, warn MPs, 30 March 2023, link
[6] NHS Confederation, Health and care sector latest developments, 30 March 2023, link
