Integrated Care System transition

This page provides a summary of national proposals to develop integrated care systems (ICS) from April 2022; and local context for Kent and Medway. All proposals are subject to the Health and Care Bill going through Parliament during 2021/22.

The four core purposes of an integrated care system are to:

  1. Improving outcomes (population health and care)

  2. Tackling inequalities in outcomes and access

  3. Enhancing productivity and value for money

  4. Supporting broader social economic development

Collaborating as ICSs will help health and care organisations tackle complex challenges, including:

  • improving the health of children and young people
  • supporting people to stay well and independent
  • acting sooner to help those with preventable conditions
  • supporting those with long-term conditions or mental health issues
  • caring for those with multiple needs as populations age
  • getting the best from collective resources so people get care as quickly as possible.

The proposed changes in the Bill include two core elements.

Integrated care systems will develop to include two new elements, alongside existing partnerships and statutory organisational arrangements:

A system level Integrated Care Partnership (ICP) is the collective of all local partners including NHS organisations, local authorities and other key stakeholders.

The partnership will be responsible for agreeing an integrated care strategy for improving health and well-being across the whole of Kent and Medway. This will involve using the best insights from data available, built bottom-up up from local assessments of needs and assets identified at place level, and focusing on reducing inequalities and addressing the consequences of the pandemic for communities.

The Partnership will be a joint committee of the two local authorities and the NHS Integrated Care Board.  Its terms of reference will be determined locally and any decision making responsibilities (if any) outside of developing the integrated care strategy will be delegated by partner organisations. 

Membership will include local authority and ICB representation plus representatives, yet to be agreed, from:

  • health and wellbeing boards;
  • other statutory organisations;
  • voluntary, community and social enterprise (VCSE) sector partners;
  • social care providers; and
  • organisations with a relevant wider interest such as employers, housing and education providers.

The membership may change as the priorities of the Partnership evolves.

Once established, the integrated care partnership will be required to hold meetings in public and publish related papers online.

Integrated Care Partnership previously reffered to the four local partnerships sitting within the Kent and Medway system. These are now called Place Based Partnerships.

Subject to legislation being passed, Clinical Commissioning Groups will be replaced by new NHS statutory organisations from April 2022. These are currently called the "NHS ICS body". In Kent and Medway there would be one organisation covering the same boundaries as the current CCG.

 

Responsibilities of the integrated care board 

 

  • Establishing joint working arrangements with partners that embed collaboration as the basis for delivery of joint priorities. The ICB may choose to commission jointly with local authorities across the whole system and at place where that is the relevant local authority footprint.
     
  • Developing a plan to meet the health needs of the population within their area, having regard to the partnership’s strategy and the local health and wellbeing strategy.
     
  • Arranging for the provision of health services in line with the allocated resources across the ICS footprint through a range of collaborative leadership activities, including: putting contracts and agreements in place to secure delivery of its plan by providers; convening and supporting providers to lead major service transformation programmes; and putting in place personalised care.
     
  • Allocating resources to deliver the plan by deciding how its national allocation will be spent across the system.
     
  • Leading system implementation of the People Plan by aligning partners across each ICS to develop and support the ‘one workforce’.
     
  • Leading system-wide action on digital and data to drive system working and improved outcomes.  This includes using joined-up data and digital capabilities to understand local priorities, track delivery of plans, monitor and address variation and drive continuous improvement in performance and outcomes.
     
  • Working alongside councils to invest in local community organisations and infrastructure and, through joint working between health, social care and other partners including police, education, housing, safeguarding partnerships, employment and welfare services, ensuring that the NHS plays a full part in social and economic development and environmental sustainability.
     
  • Driving joint work on estates, procurement, supply chain and commercial strategies to maximise value for money across the system and support these wider goals of development and sustainability.
     
  • Establishing governance arrangements to support collective accountability between partner organisations for whole-system delivery and performance, underpinned by the statutory and contractual accountabilities of individual organisations, to ensure the plan is implemented effectively within a ‘system financial envelope’ set by NHSE.

 

The Board of the organisation

The statutory minimum membership of the board will be confirmed in legislation. In most cases they will include the following roles:

  • Independent Chair plus a minimum of two other independent non-executive directors. 
  • Chief Executive
  • Director of Finance
  • Director of Nursing
  • Medical Director
  • at least one member drawn from NHS trusts and foundation trusts who provide services within the ICS’s area
  • at least one member drawn from general practice within the area of the ICS NHS body
  • at least one member drawn from the local authority, or authorities, with statutory social care responsibility whose area falls wholly or partly within the area of the ICS NHS body.

In Kent and Medway, we are discussing options for additional board roles to ensure effective representation across the area; recognising we are one of the largest Integrated Care Systems in the country with four place based partnerships and two top tier local authorities.

In Kent and Medway we will be drafting and engagement framework for the ICS to be in place for the changes in April 2022.

The engagement framework will cover how partners in the integrated care system will listen consistently to, and collectively act on, the experience and aspirations of local people and communities.

This includes:

  • supporting people to sustain and improve their health and wellbeing, as well as
  • involving people and communities in developing plans and priorities, and continually improving services.

It is expected that the NHS Integrated Care Board will have a legal duty to make arrangements to involve patients, unpaid carers and the public in planning and commissioning arrangements.​​

Statutory guidance on patient and public participation in ICSs is expected to be provided once legislation is finalised.

Kent and Medway ICS diagram from April 2022 Kent and Medway ICS development timeline

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