Integrated care systems

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Integrating Care – The next steps to building strong and effective integrated care systems across England

This document, Integrating Care – The next steps to building strong and effective integrated care systems across England, builds on previous publications that set out proposals for legislative reform and is primarily focused on the operational direction of travel. It opens up a discussion with the NHS and its partners about how Integrated Care Systems (ICSs) could be embedded in legislation or guidance. Decisions on legislation will of course then be for Government and Parliament to make.

This builds on the route map set out in the NHS Long Term Plan, for health and care joined up locally around people’s needs. It signals a renewed ambition for how we can support greater collaboration between partners in health and care systems to help accelerate progress in meeting our most critical health and care challenges.

Over the last two years, ICSs have been formed across England.  In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS care, and improving the health of the population they serve. Integrated care systems have allowed organisations to work together and coordinate services more closely, to make real, practical improvements to people’s lives. For staff, improved collaboration can help to make it easier to work with colleagues from other organisations. And systems can better understand data about local people’s health, allowing them to provide care that is tailored to individual needs.

By working alongside councils, and drawing on the expertise of others such as local charities and community groups, the NHS can help people to live healthier lives for longer, and to stay out of hospital when they do not need to be there.

We want every part of the country to build on the earliest ICSs’ experiences

It details how systems and their constituent organisations will accelerate collaborative ways of working in future, considering the key components of an effective ICS and reflecting what a range of local leaders have told us about their experiences during the past two years, including the immediate and long-term challenges presented by the COVID-19 pandemic.

These are significant new steps towards the ambition set out in the NHS Long Term Plan, building on the experience of the earliest ICSs and other areas. Our challenge now is to spread their experience to every part of England. From April 2021 this will require all parts of our health and care system to work together as Integrated Care Systems, involving:

  • Stronger partnerships in local places between the NHS, local government and others with a more central role for primary care in providing joined-up care;
  • Provider organisations being asked to step forward in formal collaborative arrangements that allow them to operate at scale; and
  • Developing strategic commissioning through systems with a focus on population health outcomes;
  • The use of digital and data to drive system working, connect health and care providers, improve outcomes and put the citizen at the heart of their own care.

Resources for integrated care

Integrated care case studies: Find out how local partnerships across the country are adapting to meet the health needs of their populations.

Webinars: A series of webinars in collaboration with Social Care Institute for Excellence focusing on delivering integrated care

PodcastsIntegrated Care podcast series

Films: NHS England and NHS Improvement Youtube playlist for integrated care

For further integrated care supporting resources, join the integrated care learning network: future.nhs.uk/integratedcare/grouphome

Background

In 2016, NHS organisations and local councils came together to form sustainability and transformation partnerships (STPs) covering the whole of England, and set out their proposals to improve health and care for patients.

In some areas, a partnership will evolve to form an integrated care system, a new type of even closer collaboration. In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve.

Local services can provide better and more joined-up care for patients when different organisations work together in this way. For staff, improved collaboration can help to make it easier to work with colleagues from other organisations. And systems can better understand data about local people’s health, allowing them to provide care that is tailored to individual needs.

By working alongside councils, and drawing on the expertise of others such as local charities and community groups, the NHS can help people to live healthier lives for longer, and to stay out of hospital when they do not need to be there.

In return, integrated care system leaders gain greater freedoms to manage the operational and financial performance of services in their area. They will draw on the experience of the 50 ‘vanguard’ sites, which have led the development of new care models across the country.

More information is available in: Breaking down barriers to better health and care.

In May 2020 another four areas were designated as integrated care systems (with three having been named in June 2019) meaning around half of the country’s population is now covered by an ICS. There are now 18 integrated care systems as shown below:

Map showing where the 29 integrated care systems are within England.

Find out more about some areas that are working towards developing an integrated care system:

  1. South Yorkshire and Bassetlaw
  2. Frimley Health and Care
  3. Dorset
  4. Bedfordshire, Luton and Milton Keynes
  5. Nottinghamshire
  6. Lancashire and South Cumbria
  7. Buckinghamshire, Oxfordshire and Berkshire West (Buckinghamshire and Berkshire West were already ICSs prior to June 2019).
  8. Greater Manchester (devolution deal)
  9. Surrey Heartlands (devolution deal)
  10. Gloucestershire
  11. West Yorkshire and Harrogate
  12. Suffolk and North East Essex
  13. The North East and North Cumbria
  14. South East London
  15. South West London
  16. Humber, Coast and Vale
  17. Sussex
  18. Hertfordshire and West Essex
  19. Norfolk and Waveney
  20. Bath and North East Somerset, Swindon and Wiltshire
  21. Bristol, North Somerset and South Gloucestershire
  22. Cornwall and Isles of Scilly
  23. Somerset
  24. Birmingham and Solihull
  25. Derbyshire
  26. Hampshire and Isle of Wight
  27. North West London
  28. North Central London
  29. North East London

Find out more

Sign up to the Future Health and Care bulletin, providing the latest news and events on integrating health and care across the country.