NHS England and Improvement (NHSE/I) has published Integrating Care: Next steps to building strong and effective integrated care systems across England which sets out their view for the strategic direction of system working and outlines a consultation on two new proposals to put Integrated Care Systems (ICSs) on a statutory footing.

To help our members understand what the proposals could mean for their businesses, we interpreted the proposals in the context of digital healthcare and drew upon eight key points of interest:

1. The paper is positioned to open up a discussion about how ICSs could be embedded in legislation or guidance – already as expected a number of trade bodies and lobby groups have opinions on this including The NHS Confederation and NHS Providers so the plans are likely to change.
2. It proposes a national plan to accelerate ICS development in 2021/22. NHSE/I will increasingly devolve more functions and resources from the national and regional teams to ICSs ahead of potential legislative change to be implemented from April 2022.
3. NHSE/I is seeking views on two options for putting ICSs on a fuller statutory footing than its original proposals from September 2019, both of which require legislative change – more information on these below.
4. The paper recognises the leadership role played by providers at both system and place level. NHSE/I want to support at scale collaboration between acute, ambulance and mental health providers and place-based partnerships across community services, primary care and local government (as well as other partners). This emphasis on providers and place provides a pragmatic approach to the next stage of development of system working.
5. NHSE/I is now directing ICSs to firm up their governance and decision-making arrangements in 2021/22 – whilst this is welcomed, it may result in re-organisations and changes in form and people.  This will inevitably prove frustrating and slow decision making into whether to procure your products and services.  It may mean individuals you have been having conversations with, move on, have their role change or re-direct you to different or new decision-making bodies.
6. This document confirms that NHSE/I will increasingly organise NHS finances at ICS level, giving ICS leaders responsibility for allocating a ‘single pot’ of NHS funding for their patch – this is generally welcomed and removes the split between CCGs and providers in managing finances.
7. It also reaffirms the shift to strategic commissioning at ICS level, with other commissioning activities moving to provider organisations/collaboratives/place-based partnerships.
8. The 2021/22 NHS operational planning guidance will set out further detail on the implementation of all these changes next financial year. This will be a very important document to align organisational strategies to NHS (and social care) needs and wants.

We shared a more detailed guidance document with our members so please get in touch if you’d like a copy or to arrange a call to find out more.