ICS Priorities
Integrated Care Systems (ICS) were introduced to connect the newly formed Integrated Care Boards (ICBs) and local authorities, enabling a more seamless healthcare service which could then give better visibility of the needs of patients and allow NHS organisations to more effectively meet these needs and provide the right high-quality care - with the ultimate goal of helping more people and to a greater degree of success.
In the words of NHS England: “Integrated care is about giving people the support they need, joined up across local councils, the NHS, and other partners. It removes traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services.”
ICSs began in July 2023 but were first proposed in February 2022, when the UK Government published its ‘Joining up care for people, places and populations’ whitepaper, which laid out new plans for the integration of health and social care in England and how ICSs can bring this together in line with the NHS Long Term Plan.
Local authorities and NHS England are working closely together but there is still a long way to go due to further government reform, funding changes and internal goals and targets. This is affecting the speed and timing for when these changes can be implemented and we are still feeling the disruption post-pandemic.
In this article we will explore the annual priorities of an Integrated Care System and how these goals are set and ranked. We will also discuss the hangover effect of Covid-19 and the strain on the NHS, the challenges of ongoing digital transformation, and the role providers such as The Access Group can have in aiding an ICB in delivering quality care to their local area.
NHS delays
The focus on care related to Covid-19 inevitably led to a backlog of care delivery within health and social care services across the UK; delays which raised concerns amongst the ICBs about maintaining elective activity throughout busier periods.
Whilst Covid hasn’t gone away, the levels of impact have significantly dropped since 2020/21, though the disease – and the after-effects – are still a burden on modern healthcare services. This added pressure, at a time the population is living longer, is seriously impacting staff wellbeing – with many healthcare professionals facing exhaustion and burnout and even quitting their jobs.
A Commons Health and Social Care Committee report revealed that “92% of trusts told NHS Providers they had concerns about staff wellbeing, stress and burnout following the pandemic” (Workforce burnout and resilience in the NHS and social care, 2021). Social care is also facing a workforce crisis and struggling with recruitment, aggravated by the impact of lockdowns, low pay and continually changing requirements.
This then poses a question about how integrated care systems are focusing their efforts to tackle these delays and catchup with overdue care delivery, given issues with staff retention, job vacancies, and budget squeezes in the face of inflation and government strategy. The conclusion we keep returning to is the need for complete digitisation (or near as possible). The Covid-19 pandemic highlighted the importance and need for digital transformation to accelerate the delivery of care and in the process the reduction of the clinical backlog. Digitisation was already slowly progressing, especially with the push for integrated care through ICBs, but to properly establish shared services, and to have the ability to access data and reporting for improved wellbeing and care of patients and staff it needs a bigger push.
This push has started to come into play as of March 2024, with Digital Health reporting that Chancellor Jeremy Hunt’s Spring Budget promised an extra £3.4 billion of new investment. In the UK government budget statement, they said: “The NHS in England will receive… £3.4 billion in capital investment over the forecast period to help unlock £35 billion in productivity savings over the next Parliament by harnessing new technology like AI and cutting admin workloads”.
CCG to ICB transition
Original ICS priorities focused on transforming Clinical Commissioning Groups (CCGs) into Integrated Care Boards (ICBs) to partake in Integrated Care Systems (ICSs) by April 2021, with further work to align financing, processes, staffing and services. This was pushed back to July 2022, but did then launch.
Although simple in theory, the work in practice was far more challenging. Uniformed staff structures needed to be aligned across each CCG within the same ICS, and this meant change for many teams, with roles being replaced or adjusted. According to Pharmacy Magazine, staff restructuring should have been completed by December 2021: “ICS are expected to have completed due diligence and preparations for staff and property transfers from CCGs to the new ICS bodies.”
The government also worked to provide support for financial structuring, as outlined in the 2022 whitepaper: “We will work with partners to develop guidance for local authorities and the NHS to support going further and faster on financial alignment and pooling.”
Healthcare digital transformation
As part of NHS England’s digital transformation plans and long-term plan, the NHS is prioritising digital transformation to improve access, data and future improvement planning within healthcare.
ICS bodies need to avoid the duplication of systems, technology or work, for a streamlined service. Many CCGs are at different points in this process and are using a variety of technologies.
ICSs will, therefore, not only need to amalgamate these products and systems but also plan to improve upon current, outdated products. This is a great opportunity to bring health and social care into the future and develop some standardisation across the sector.
Managing growth and scalability
Many larger ICSs which are already comprised of merged or multiple CCGs have had a harder time directing the scale of change. However, digital transformation will allow these integrated care systems to manage new growth and scale with time.
Local authorities are well placed to provide a unique understanding of the challenges communities are facing to deliver care. ICS collaboration reduces the crossover of services, helping ICSs to react faster and to see the council’s available marketplace, but it also saving wasted expenditure on duplication of these services.
By building upon systems and process which allow for better communication and connection with local authorities and community services, integrated care systems can transform existing local care provision. This means improved responses, better urgent care and greater access to services such as primary care and mental health support.
Communities also have a more direct line to offer feedback and solutions through an ICS. This further opens the marketplace for new providers, and in turn reduces pressure on staff; improving their wellbeing, bolstering recruitment and enhancing care through the empowerment of clinicians.
This management of growth, and the scale of growth, requires accurate data to support good financial management. When talk about digitisation, we’re not just talking about software solutions for specific health and care services. We’re also talking about solutions to make sure that operational administration is effective too.
Data and reporting
Bringing together multiple organisations and services requires a clear oversight of what’s going on via data and reporting. The NHS and local authorities manage huge amounts of confidential data which not only needs to be secured correctly but also must remain accurate and up to date if we are to ensure high quality care and efficient services. It is therefore crucial to bring these data streams together whilst remaining secure and precise.
To support this, NHS England and NHS Digital have laid out plans for the patient level data set which sets out requirements and standardisation for the data of NHS Continuing Healthcare (CHC) patients and how this is collected, stored and reported. It pulls together ICB and ICS reports into one system for both high and low level reporting. Anyone working within or with the ICS reports the same centralised data set, with interoperability ensuring that each service can access the correct patient data when required and contribute to a holistic approach to treatment.
ICS and providers
Providers have seen some changes in commissioning, with ICSs responsible for procurement and commissioning.
“Securing the provision of health services to meet the needs of the population by taking on the commissioning functions that currently reside with clinical commissioning groups (CCGs) alongside some of those that currently reside with NHS England” (The Kings Fund, 2021).
By bringing CCGs under an ICS as the integrated care boards we see today, more visibility has been given over the market and the providers available within it. This insight has helped make further improvements to community care and understand where/if care is lacking in any given area.
Providers, like Access Adam, are working closely with ICBs, local authorities and other NHS providers to collaborate and bring systems inline for ICS integration. By working together, it ensures the products fit with individual ICS’s needs and requirements while providing the correct reporting tools for integrated care.
At Access Adam Care Commissioning we are also working with ICB and local authority suppliers in the local community to develop a solution that suits all parties; reducing admin time, integrating with other systems and technologies, securing data, and making information accessible from anywhere for those with assigned permissions. This not only improves relationships but provides another source of communication between suppliers, and a smoother transition for integration.
Discover how our commissioning software can help support your ICS. Contact our team today!
