Steps towards Integrated Care

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2 min read
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Some elements of NHS commissioning structures have a way of coming full circle and unfortunately the old adage of “never throw away the signs” has a ring of truth to it!

Back in 2013 when Primary Care Trusts were replaced by Clinical Commissioning Groups, the expectation was the new GP-led CCGs would be more responsive to the needs of local patients and be able to implement rapid on the grounds changes.

CCGs have delivered outstanding levels of clinical engagement, and in parts of the country delivered innovative solutions to decades old problems. However, with 211 separate commissioning bodies, and Governing bodies appointed on a localism agenda, the ability for CCGs to work seamlessly together on strategic issues was always going to be a challenge.

Now, as laid out in the NHS Long term plan, there is a move to significantly accelerate the development of Integrated Care Systems (ICSs), with a deadline for England wide coverage of April 2021. A key challenge is whether systems can retain the clinical engagement and local focus delivered by CCGs, while also getting Neighbourhoods and Places working together on scale solutions to benefit their patients.

The plan outlines three broad priority areas for ICSs:

System Leadership

  • Every ICS will need streamlined commissioning arrangements to ensure a single set of commissioning decision at the system level. This will typically involve a single CCG for each ICS area.
  • National support will be provided to each developing system to produce and implement a clear development plan and timetable.
  • NHS organizations will be encouraged to support each other with a ‘duty to collaborate’.

Reducing Variation

  • The reduction of unwarranted variation will be a core responsibility of ICSs
  • Supported by national programmes, ICSs will be encouraged to bring together clinicians and managers to implement standardised evidence-based pathways of care.

Performance Improvement

  • NHS England and Improvement are working on a new ICS accountability and performance framework.
  • This will provide a consistent and comparable set of performance measures and then help generate a set of system-wide objectives.
  • If local systems can demonstrate a track record of strong financial and performance delivery, they will be given greater control over resources.

How Clarity can help

We have expertise in the following areas which will support and accelerate the development of your ICS:

  • Health needs assessments at Neighbourhood, Place and System levels.
  • CCG integration and merger expertise. We are currently supporting two systems on their integration journey.
  • Organizational development, coaching and mentoring programmes.
  • Extensive experience of system-wide care pathway improvement, with recent projects completed in: MSK redesign; Community Dermatology; Elective care resilience; Outpatient redesign and Non-elective flow.
  • Analytical expertise in the development of system-wide performance dashboards

If your Health and Care system would like support, get in touch below.

Achieve Lasting Change

We're ready to work with you to create a customised plan to deliver sustainable change for your system.


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