It is widely agreed across the health sector that a more integrated way of working with partners across local government and the VCSE sector is the right direction of travel and are committed to building successful relationships within our systems to work in this way to improve patient outcomes. In order to do this, the ICS role and that of its leaders is essential in convening and bringing together those partners, both within the ICB and the ICP.

Each Integrated Care System is unique, covering a different geographical footprint, population sizes, and system complexity. ICSs are all at different stages of their development, but many have however been working closely with their local authority, voluntary and community services sectors for some time, coordinated through Health and Well-being Boards. Since ICBs became statutory organisations there has been significant change for many, restructuring and finalising important leadership and governance arrangements.

• All ICSs have four key purposes, namely:
  • improving outcomes in population health and healthcare
  • tackling inequalities in outcomes, experience and access
  • enhancing productivity and value for money
  • helping the NHS support broader social and economic development.

• Our integrated care board (ICB) holds responsibility for planning NHS services, including those previously planned by clinical commissioning groups (CCGs). As well as a chair and chief executive, membership of the board includes ‘partner’ members drawn from local authorities, NHS trusts/foundation trusts and general practice. Our ICB ensures that services are in place to deliver the integrated care strategy developed by the integrated care partnership.
• Our integrated care partnership (ICP) operates as a statutory committee. It is made up of partners from across the local area, including voluntary, community and social enterprise (VCSE) organisations and independent healthcare providers, as well as representatives from the ICB. One of the key roles of the partnership is to assess the health, public health and social care needs of the area it serves, and to produce a strategy to address them. This, in turn, directs the integrated care board’s planning of health services and local authorities’ planning of social care services.

• The breadth of responsibilities that our ICB is required to fulfil is wide and includes (to name just some) procuring services, having the statutory duty around quality and safeguarding, having the statutory duty around public involvement, leading financial management, leading performance management, leading EPRR, overseeing primary care at scale, leading workforce planning and developing a “one-team” people strategy.
• Within ICBs there is much ongoing work with many still in the stages of merging teams, restructuring teams, managing teams inherited from predecessor Clinical Commissioning Groups (CCGs).
• This is against the backdrop of one of the most challenging periods in the NHS’s history; coping with the ongoing impact of the Covid-19 pandemic, an increasingly stretched social care service that is unable to take on patients who could be discharged from hospital, an over stretched ambulance service and a Primary Care service delivering record numbers of patient appointments to cope with the increased demand.
• Many systems are reviewing their staffing levels and structures to identify potential opportunities to streamline structures and improve efficiency.

In addition, in order to streamline structures, ICBs have to take into account the forthcoming delegation of responsibility to them for commissioning pharmacy, ophthalmology and dentistry services in 2023, alongside some specialised services and public health functions (such as screening and immunisation) thereafter. ICBs are also required to develop system workforce plans to support delivery of more integrated care ensuring we have the right people, with the right skills in the right place.

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For more information about how we are Developing our ICS, please click here.