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Integrated Care Systems boosted in new guidance

The move towards system working through STPs and the voluntary roll-out of Integrated Care Systems will be reinforced throughout 2018/19. 


‘Refreshing NHS Plans for 2018/19’, published by NHS England and NHS Improvement, provides updated guidance for how commissioners and providers should refresh their plans for 2018/19. All STPs are expected to take an increasingly prominent role in planning and managing system-wide efforts to improve services. It is anticipated that more STPs - those that can demonstrate an ability to take collective responsibility for financial and operational performance and health outcomes - will join the Integrated Care System development programme.


Integrated Care System is now being used as a collective term to describe both devolved health and care systems (Greater Manchester and Surrey Heartlands) and those previously designated as shadow accountable care systems, of which there are currently eight. 


Cross-organisational planning and control is the emphasis in Integrated Care Systems, involving the NHS provider and the CCG with a re-designed model of care that brings in community-based and home-based services, in partnership with social care, the voluntary and community sectors to provide more integrated services.


New operational and financial guidance is set out.  Existing Integrated Care System areas should now prepare a single system operating plan, rather than individual organisational narratives. Under new financial arrangements they are encouraged to adopt a fully system-based approach to the PSF and CSF. All Integrated Care Systems will be required to operate under system control total incentive structures by 2019/20.


In the guidance, NHS England and NHS Improvement state that they envisage that Integrated Care Systems will replace STPs over time. They will aim to review any applications to join the Integrated Care System programme from STPs that can now demonstrate their readiness by March 2018.  


The next cohort of Integrated Care Systems will be selected from STPs with strong leadership and mature relationships, including with local government; a track record of delivery and evidence of tangible progress towards delivering the priorities in the Next Steps on the Five Year Forward View; strong financial management with collective commitment to system planning and shared financial risk management; a coherent and defined population that reflects patient flows; and compelling plans to integrate primary care, mental health, social care and hospital services.


In moving towards Integrated Care, systems are expected to involve and engage with patients and the public, their democratic representatives and other community partners. 

In a statement, Niall Dickson, Chief Executive of the NHS Confederation, which represents organisations across the healthcare sector, says: “We fully support the continuing focus on integration across health and social care and the emphasis on the evolution of Integrated Care Systems. They are not and will not be panaceas, but they are necessary and we will support our members in helping to take this important reform forward.” 

Download the full guidance document here.