Care England is delighted to have published our latest report From Inception to Implementation: A Year of Integrated Care Systems. This report reflects on the first year Integrated Care Systems (ICSs) came online and seeks to tackle the question of what is working well, what isn’t, and how we can improve integration further.
Integration between health and social care is not a new idea. Since the inception of the NHS in 1948, there have been continuous discussions about how we can better support the journey and individuals who move around the health and social care sector. There have been countless attempts, and millions of pounds wasted on previous initiatives designed to deliver integration, and we owe it to our citizens to ensure this time we succeed.
In 2012 clinical commissioning groups (CCGs) were introduced, shortly followed by the Sustainability and Transformation Plan (STPs) in 2015. While these entities helped lay the foundations for the meaningful steps towards integration that we are now seeing manifest, they failed to address historic barriers that have prevented true integration.
The introduction of ICSs has presented a real opportunity for these historic barriers to be brought down and for all sector partners to collaborate and contribute towards reshaping the health and social care sector. While it has only been one year since the 42 Integrated Care Boards and Integrated Care Partnerships gained their statutory powers, we must regularly reflect and review the progress of these new systems or how they have plateaued.
In April Patricia Hewitt, chair of Norfolk and Waveney ICS, published her review of ICSs, commissioned by the Government as part of the November Budget in 2022. While this review offered a diverse range of recommendations and paid homage to the importance of adult social care, we took it upon ourselves at Care England to produce a report that solely reflected on the integration agenda through the lens of adult social care.
The report represents our endeavour to comprehensively analyse and reflect upon the first year of ICSs. We felt it was vital to capture the views of ICS leaders in the development of this report, not only to validate our recommendations but also to reflect the importance of health and social care colleagues working together to foster true integration within the wider system. As such, we conducted in-depth interviews with 11 ICS leaders from across the country to serve as the cornerstone of this report.
The report’s recommendations tackle key discussion points highlighted by ICS leaders, from commissioning to digital transformation and workforce. A core theme, however, of the report that all ICS leaders reflected is the issue of funding. This is particularly important as we move towards a prevention agenda. Our population is ageing rapidly, with it being recognised as having a potentially destructive impact on our health and social care sector if left unaddressed and the right measures are not implemented. Yet, Government policy does not reflect this discourse. The recommendations within From Inception to Implementation, if implemented, will help ensure the longevity and sustainability of not just the health and social care sector but ICSs too. We want to work with both Government and system leaders to make these recommendations work for all partners.
From our discussions with ICS leaders, there is a clear desire to explore how we can better join health and social care partners, build on existing forums and establish an agenda that addresses health inequalities and ensures the sector’s longevity. Through dynamic commissioning reform and redistribution of resources, we can, as health and social care partners, build a long-sustaining system that can be adapted in the decades to come as long term and complex conditions become more prevalent.
Care England members are eager to become more involved in the intricate discussions within all layers of their ICSs. As we move into year two of the ICSs journey, I challenge system leaders on how they will accommodate and include the diverse range of social care providers within their locality. Care England is here to support ICSs with this task, and we are dedicated to ensuring that the integration agenda succeeds.
Professor Martin Green is chief executive of Care England
@CareEngland
