The challenges of developing integrated care partnerships (ICPs): a discussion

The challenges of developing integrated care partnerships (ICPs): a discussion
NHS Confederation 10 November 2021

• A summary of issues raised by ICS leaders following the publication of the national ICP engagement document.

FutureNHS ICS GUidance

ICS Guidance
FutureNHS platform [registration required]

• The ICS Guidance workspace includes the latest suite of guidance and resources to support ICS transition and development throughout 2021/22 and beyond. It includes a list of published ICS resources.

Integrated care systems: how will they work under the Health and Care Bill?

Integrated care systems: how will they work under the Health and Care Bill?
Kings Fund 18 October 2021

• Integrated care systems are part of a fundamental shift in the way the health and care system is organised. A new diagram shows how planning and partnership bodies could work together based on the provisions currently drafted in the Bill.

ICP Engagement document : ICS implementation

Integrated Care Partnership (ICP) engagement document: Integrated Care System (ICS) implementation
DHSC, NHS England updated 20 September 2021

• This engagement document is focused on the role of Integrated Care Partnerships (ICPs) within statutory arrangements for Integrated Care Systems (ICSs). The guidance builds on NHS England and NHS Improvement (NHSEI)’s ICS Design Framework to provide more detail on the role of ICPs, the statutory framework, guiding expectations and the timing of implementation. It includes a list of FAQs which we hope address stakeholders’ immediate questions.

Is Manchester Greater? A New Analysis of NHS Integration

Is Manchester Greater? A New Analysis of NHS Integration
Centre for Policy Studies 5 September 2021

• This report scrutinises the performance of pioneering integration schemes in Greater Manchester, West Yorkshire and then more broadly across England in the years before the pandemic. It attempts to evaluate their performance compared both to other areas of the country, and the original targets set.

Clinical and care professional leadership in integrated care systems

Clinical and care professional leadership in integrated care systems
NHS Confederation 3 September 2021

• A thematic report from engagement events in March 2021 and mini literature review to inform guidance to support embedding system-wide clinical and professional leadership in all integrated care systems.

Who Pays for What proposals

Who Pays for What proposals
NHSX 31 August 2021

• A description of the barriers to investment in digital technology and how NHSx propose to start to fix them in 2021 to 2022 and beyond to support ICSs. 
• Part of NHSX Digitise, connect, transform: Guidelines for digitised healthcare

Guidance for Integrated Care Boards

Guidance on Integrated Care Systems
NHS England 19 August 2021

• NHS England has published more guidance for ICSs including:
• Interim guidance on the functions and governance of the integrated care board - proposed core components of integrated care board (ICB) governance arrangements.
• HR framework for developing integrated care boards - key activities, responsibilities and/or considerations required at a national, regional, system and organisational level for dealing with the change processes required to affect the transfer and the transition to ICSs.
• Building strong integrated care systems everywhere: guidance on the ICS people function – supplementing the ICS Design Framework and building on the NHS People Plan. It is intended to help NHS system leaders and their partners support their ‘one workforce’ by delivering key outcome-based people functions from April 2022.
• Part of  NHS England Integrated Care Systems: Guidance

NHS Providers next day briefing - integrated care board governance

NHS Providers 20 August 2021

• This document summarises the NHS England governance guidelines and provides detailed commentary on the ICB functions and governance guidance, model constitution and ICS people guidance.

Working together at scale: Guidance on Provider Collaboratives

Working together at scale: Guidance on Provider Collaboratives
NHS England 10 August 2021

• The ICS Design Framework set an expectation that provider collaboratives will be a key component in enabling ICSs to deliver their core purpose. This describes the roles of different organisations and services and outlines minimum expectations for how providers should work together in provider collaboratives, offering principles to support local decision-making and suggesting the function and form that systems and providers may wish to consider.
• Part of https://www.england.nhs.uk/publication/integrated-care-systems-guidance/

Understanding integration: how to listen and learn from people and communities

Understanding integration: how to listen and learn from people and communities
Kings Fund 21 July 2021

• People’s experiences of health and care services are usually collected and understood at the level of individual providers but this does not give an understanding about whether these services are working well together to meet people’s needs. This guide, produced by Kings Fund, Picker and NHS England/Improvement, is a practical guide for partners working in these systems, with ideas on how they might go about this.

Addressing the care backlog

Addressing the Care Backlog: An Essential Partnership Between Primary And Secondary Care
NHS Providers July 2021

• A contribution to the debate about how organisational development across neighbourhoods, places and integrated care systems (ICSs) might be achieved, with relevant case studies for colleagues in providers of all types and sizes.

Less noise and more light: using criteria-driven analysis to tackle inequalities

Less noise and more light: using criteria-driven analysis to tackle inequalities
The Strategy Unit June 2021 

• Analysis produced for the Black Country and West Birmingham addressing the steps needed to address health inequalities.
• It covers 21 clinical areas and looks at inequalities across ethnic and socioeconomic groups. But it does so using a single outcome measure: emergency hospital admission rates. This outcome is distressing for individuals; expensive for systems; and indicative of broader problems. It simplifies inherent complexity.
• We show both the scale (numbers affected) and the degree (the relative unevenness of admission rates across subgroups) of the problem. Applying these criteria cuts through the noise often generated by the proliferation of ever-fuller data sets. It shows Black Country and West Birmingham where the gains are.
• We find that people from specific ethnic minority groups are far more likely to be discharged from hospital without a firm diagnosis coded in their record. There are many possible explanations, but we have ruled out data quality. This requires attention: ICSs cannot address what they cannot see.

Health and Care Experience Profiles

Health and Care Experience Profiles: Understanding how services work together
Healthwatch 17 June 2021

• Healthwatch has developed a qualitative research methodology – the Integration Index - that local health and care systems can use to better understand people’s experiences using integrated services. The more comprehensive Integration Index work will form part of the developing accountability and performance frameworks for Integrated Care Systems (ICS). Using various quantitative tools, ICS can track how integrated care is delivered against Long Term Plan commitments. 
• However, to understand whether integration improves people’s experiences in different communities Healthwatch has published a methodology for the local integration index that ensures people’s experiences inform how services work together by reviewing existing policies and data while measuring how patients, service users and carers think local services provide joined-up and personalised care. This methodology will sit alongside other quantitative tools for use by ICS. A number of pilots have developed Health and Care Experience Profiles for five groups.

Integrated Care Systems: Design framework

Integrated Care Systems: Design framework
NHS England 16 June 2021

• These documents set out the headlines for how NHS England will ask NHS leaders and organisations to operate with their partners in Integrated Care Systems (ICSs) from April 2022 and guidance in respect of what the employment commitment is, its application in practice and how it affects people.

Exploring Feedom to Speak Up in Primary Care nad Integrated Settings

Exploring Freedom to Speak Up in Primary Care and Integrated Settings
National Guardian June 2021

• This report presents an overview and key findings of the work carried out by the National Guardian’s Office (NGO) in partnership with colleagues in primary care and integrated settings to support the growth of Freedom to Speak Up and the introduction of the Freedom to Speak Up Guardian role.
• It identifies two models to support primary care organisations in developing their speaking up arrangements:
• Freedom to Speak Up within an organisation – such as a GP practice or Dental surgery; or a CCG
• Freedom to Speak Up within a network or defined structure – for example a partnership; a local support; or an Integrated Care System Model.

The role of primary care in integrated care systems

The role of primary care in integrated care systems
NHS Confederation 27 May 2021

• This report sets out the views of primary care members on the underpinning principles needed for strong primary care involvement at system and place.

Health and Care Bill and responses

Working together to improve health and social care for all
DHSC 11 February 2021

• White paper setting out legislative proposals for a Health and Care Bill. These proposals are designed to support our health and care system to work together to provide high-quality health and care, so that we live longer, healthier, active and more independent lives.
• Press release: Blueprint launched for NHS and social care reform following pandemic

Legislating for Integrated Care Systems: five recommendations to Government and Parliament

NHS England 11 February 2021

• Five specific recommendations to Government on the question of how to legislate to place Integrated Care Systems on a statutory footing, 
• FAQs on NHS England and NHS Improvement’s legislative recommendations on ICSs

Responses:

• Royal College of Physicians 
• The Government’s White Paper proposals for the reform of Health and Social Care
  House of Commons Health and Social Care Committee 14 May 2021
  Consideration of the white paper proposals - Patient choice and potential implementation (Chapter 2), Integrated Care Systems (Chapter 3), social care (Chapter 4), workforce planning (Chapter 5), additional powers for the Secretary of State (Chapter 6), public health (Chapter 7) and proposals to reduce bureaucracy and increase innovation (Chapter 8)

Integrated care systems explained: making sense of systems, places and neighbourhoods

Integrated care systems explained: making sense of systems, places and neighbourhoods
Kings Fund updated 11 May 2021

• Integrated care systems (ICSs) are partnerships that bring together providers and commissioners of NHS services across a geographical area with local authorities and other local partners to collectively plan health and care services to meet the needs of their population.

Provider collaboratives – time to build

Provider collaboratives – time to build
Good Governance Institute April 2021

• NHSE/I envisages collaboratives of acute, mental health and ambulance providers at ICS to allow them to operate at scale, deliver specialist care effectively and provide equal access. This guide clarifies what is meant by provider collaborative, explains the benefits and a “How to” guide on how to set up a provider collaborative.

National Quality Board - Integrated Care Systems

National Quality Board

• The National Quality Board (NQB) was formed in 2009 to champion the quality agenda, secure system alignment and drive quality improvement across the health care, social care and public health system. The NQB’s current core priorities include supporting system transformation and the integration of care and outcomes, understanding and addressing unwarranted variation and inequalities, and supporting learning and recovery from the COVID-19 pandemic.
• NQB Position Statement on Quality in Integrated Care Systems – April 2021
• Shared Commitment to Quality – Refreshed edition, April 2021
• Case Studies on Quality Oversight in ICSs – April 2021