The NHS Confederation’s six-month engagement process across its membership in England has revealed broad support for giving integrated care systems (ICSs) statutory footing in law.
With the Government expected to introduce new primary legislation affecting the NHS over the coming year, NHS leaders have set out the factors they believe should be central to a new framework for ICSs. They believe COVID-19 has demonstrated the importance of organisations from across the NHS, local government and community and voluntary organisations working collaboratively for the good of their local communities.
System working must be permanently embedded across the wide range of organisations involved in health and care and recognise the key role that local government, independent and charitable providers, voluntary sector organisations and community representatives play in systems alongside NHS services.
NHS leaders have told the NHS Confederation that giving ICSs statutory footing must be subject to certain conditions. For example, the process of moving to a statutory system must not be rushed, so ICSs should operate in shadow form for a significant period of time to allow for careful planning and the ironing out of any local issues.
Eight out of ten NHS leaders responding to the NHS Confederation survey support the creation of a shared statutory duty on NHS Trusts, Foundation Trusts, CCGs, local authorities and other system partners to build on existing partnership working, develop a sense of shared accountability for improving population-level outcomes and incentivise joint-commissioning.
There should also be radical reform of NHS oversight models to become more outcome-focused and driven by local needs and solutions. The pandemic has shown that a reduced regulatory burden is conducive to rapid innovation and so a lighter leaner oversight model should be built into the NHS to embed this permanently.
Danny Mortimer, Chief Executive of the NHS Confederation, says: “For too long, the NHS and other public services have had to work within a legislative framework that has encouraged the fragmentation of services and not recognised the importance of collaboration. What members point to in recent years are hugely positive local collaborations which better respond to the health and wellbeing needs of local communities.
“The pandemic has accelerated this direction of travel with rapid change and improvement, as organisations from across the whole of the NHS as well as local government, community and voluntary organisations, working truly collaboratively for the good of their local communities. This has resulted in lean, agile and responsive health and care, and we must seek to embed this for the long term.
“Legislation alone is never the answer to resolving issues within health and care. More important are culture and relationships as well as better long-term national policy. However, the Government has an opportunity with new legislation over the coming year to fix many of the problems inherent in the existing framework that so many now find counter-intuitive. Now is the time to develop a framework, built on the experience and expertise of NHS leaders, that facilitates and incentivises collaborative working across health and care.”
