Integrated Care System Formation in a Pandemic

April 2021 marks the deadline for all of England to be part of an Integrated Care System (ICS), as outlined in the NHS Long Term Plan. With 29 ICSs already confirmed, the majority of England is covered, with 13 more geographical areas to finalise.

The idea behind ICSs is to draw together NHS service providers, local authorities, commissioners, and other partners who are involved in health care to work together collaboratively in order to provide more efficient services in an area, ultimately changing how health and care services are planned, paid for, and delivered. The concept of ‘System’ (ICS level) and ‘Place’ (town/district) are useful here: ICSs have the power to decide what services are best kept at ‘System’ level, to benefit from the economies of scale (a typical example would be mental health services), and what services are kept at a ‘Place’ level (such as specialised services). The diagram below highlights the typical characteristics of ‘System’, ‘Place’, and also ‘Neighbourhood’, which make up an ICS.

ICS Diagram.png

COVID has, in many places, been highly beneficial at either forming or further strengthening the provider collaborative ties that are so integral to a functioning ICS. Even in areas where ICSs are not yet a formalised arrangement, the ‘on the ground’ experience of working together in a pressurised environment will be beneficial moving forward. The CQC cited an example of good collaborative working during the pandemic between the East Suffolk & North Essex Foundation Trust Oncology department and Nuffield Health Ipswich Hospital, where Oncology patients needing chemotherapy treatment were being seen at the private hospital, to ensure better patient flow at the NHS site. This kind of collaborative working between partners who are traditionally competitors is at the heart of effective ICSs.

In the face of the largest challenge the NHS has faced in its 70-year history, it is no surprise that the formation of the last 13 ICSs has been affected by the pandemic. But the pandemic has shown that the cited potential and benefits of collaborative working can be realised. We can only hope that the danger of ‘very boring discussions’ (UCL Hospital Foundation Trust Chief Executive, Marcel Levi) quashing the progress of ICSs with too much bureaucracy will be overcome by the COVID-inspired fervour of collaboration, to bring all areas of England into a local ICS soon.

Written by Sophie Burton, Bid Manager at HealthBid

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