So what’s new? Most people who have worked around the NHS for a number of years have a feeling that if you wait a while all things come back to where they used to be.
Remember Strategic Health Authorities? Part of the structure of the NHS in England between 2002 and 2013 responsible for enacting the directives and implementing fiscal policy as dictated by the Department of Health at a regional level. So are the new Integrated Care Systems (ICS) just a reinvention of these?
So how have we ended up here?
In 2016, NHS organisations and local councils formed 44 sustainability and transformation partnerships (STPs) covering the whole of England, and set out their proposals to improve health and care for patients as NHS England and other national bodies emphasised the need for providers and commissioners to collaborate in addressing the challenges they face.
Based on the previous work of the new care models they set out ambitions to integrate care and transform services. From the 44, 10 ICS areas were selected on the basis of the quality of their STPs and an assessment of their ability to work at scale to demonstrate progress in taking forward the ambitions of the Forward View.
The future seems to be a move that other areas will become Integrated Care Systems where they can demonstrate strong leadership, a track record of delivery, strong financial management, a coherent and defined population, and compelling plans to integrate care. A further four ICS areas were selected in May 2018, there is no timeframe set for further roll out at this stage.
Adding councils is new
In an Integrated Care System, NHS organisations with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve. There is often a blurring of the lines between what is social care and what is healthcare, sometimes to the detriment of the service provided to the consumer. This new approach can be seen as a move to address this and remove budget silos.
Where’s the win for the system?
They should provide a long wished for, both by suppliers of new innovations and the health system itself, opportunity to spend on prevention and pathway change where the return will take more than a year to be realised.
The NHS for many years has focused on in-year returns on investment leading to severe difficulty in long-term spend to save programmes. That added to a silo budget where there is no real motivation to spend on your budget to save on somebody else’s has made deploying new ideas and moving the point of healthcare delivery has remained in stasis when change is what was really needed, just look at the relatively poor take up of telehealth monitoring for an example.
The opportunity presented is to design a system that works for the patient and not the provider of health and care.
The collective responsibility of NHS organisations, local councils and others, for managing resources, delivering NHS standards, and improving the health of the population they serve will challenge the current operating models.It’s hoped they will help staff from different agencies to work together more easily, utilising data about local people’s health and allowing them to provide care that is tailored to individual needs. This is what many within the NHS and suppliers as well as patients have felt for a while has been where the system has issues, so a step forward here can only benefit all the stakeholders.
In return, ICS leaders gain greater freedoms to manage the operational and financial performance of services in their area a step away from the annual only spreadsheets.
This along with the work of the AHSN network to spread new innovations could be the step forwarded needed to replace our reliance on hospital based care systems in England.
Do they need new ideas?
Having attended a recent meeting, where an ICS was looking at new opportunities, it rapidly became apparent that rather than needing new solutions for problems in the system what they really need to be able to do is cross silo budgets and deploy many of the great ideas that are already out there.
What can the AHSN offer?
The AHSN’s are already working across all the organisations that make up an ICS and with our links to both the health system and industry suppliers we will be looking to support both with ideas and information in the coming months.
What’s the future?
Will they be the answer to the ever growing demands on the health system? Only time will tell but for now they appear a step in the right direction.
Author
Nick Brown - Commercial Manager
Nick manages and develops our industry engagement and provides advice to partners across sectors on commercial partnerships and innovations.