Our current focus
In September the Health Devolution Commission held its third Integrated Care Systems Best Practice Roundtable. A recording of the well attended Zoom meeting, which focussed on two issues, is here. In part one the focus was ICSs and Progress towards Integration. This was addressed by:
- Sarah Walter – Director, ICS Network, NHS Confederation – slides here
- Jason Yiannikkou – Director, Systems, Integration and Reform Directorate, Department of Health and Social Care
In part two the focus was ‘Better Housing for Better Health: What are the Top 5 Actions by ICSs to Develop Best Practice?’ This was addressed by :
- Lord Best – Co-chair of the Housing and Care for Older People APPG; Vice-chair of the Homelessness APPG; and Vice Chair of the Healthy Homes and Buildings APPG
- Dave Buck – Senior Fellow at the King’s Fund where he has a particular focus on Public Health and Inequalities – slides here.
- Noel Sharpe – Chief Executive of the Bolton at Home housing association and the Health and Housing lead for Greater Manchester Housing Providers – and her colleague Helen Simpson.
The meeting was informed by a comprehensive background briefing paper here. A report with three recommendations for strengthening integration and 5 recommendations regarding how ICSs can help to ensure better housing for better health outcomes is available here.
In June the Health Devolution Commission held its second Integrated Care Systems Best Practice Roundtable. This first heard from Andy Harrop, General Secretary, the Fabian Society and author of ‘Support Guaranteed’ – slides here – after which it discussed the future of social care policy. In the second half of the meeting the focus switched to ICSs’ support for broader social and economic development with five excellent speakers:
- Sandra Husband, Honorary Secretary, the Association of Directors of Public Health and DPH, Hackney
- Mark Rowland, Chief Executive, Mental Health Foundation – presentation here
- Cathy Elliott, Chair, West Yorkshire Health and Care Partnership – presentation here
- Metro Mayor Oliver Coppard, Chair, South Yorkshire Integrated Care Partnership
- Matt Neligan, Director of System Transformation, NHS England
The comprehensive background paper that informed this meeting is here. The report of the meeting is here.
In May the Commission responded to the Government’s call for evidence on its proposed Care Workforce Pathway for Adult Social Care. The letter from Co-chair Rt Hon Sir Norman Lamb welcomes “the intention of creating a clearer workforce pathway for adult social care that will help to overcome the misguided perception of care work as low skilled. The pathway, with its proposals about different roles and their associated qualifications, will help support the professionalisation of the social care workforce; and this in turn will help to attract and retain people in social care as it is increasingly perceived as a genuine vocation and career.” However, it points out that the Government’s proposals fail to “address the link between care skills/responsibilities and pay/financial incentives to progress at every level” and concludes by stating that “the most fundamental challenge at present for improving social care is the low pay of care workers.”
In April the Commission published its formal response to the Hewitt Review – A Great Step Forward. It was informed by the March roundtable which had heard from Rt Hon Patricia Hewitt. The Commission concluded that there are five must do changes the government should implement to support ICSs and five other actions that need to be taken forward in conjunction with ICSs and wider partners.
In March 2023 the Commission held a roundtable focussed on the Hewitt Review of ICSs and on ICSs’ best practice in response to the cost of living crisis. The write-up of that event which includes links to the slides presented and the Commission’s five conclusions and recommendations are available here. The recording of the roundtable is available here.
In January 2023 the Commission submitted evidence to the Hewitt Review of ICSs. This concludes with a call for 13 week statutory consultation – and ideally a nationwide debate – on whatever the Government decides regarding its next steps on targets once it has considered the findings of the Review.
In December 2022 the Commission launched its end of year report “ICSs: a Great Deal Done – a Great Deal More to Do” which presented the key points and conclusions of its three thought leadership roundtables (see below) that have focused on emerging and developing ICS best practice.
At the launch in Parliament there was endorsement for the report from speakers from across the political parties and from across the health and care services. The clear ‘consensus’ message that emerged was that ICSs present an excellent opportunity to deliver the better – more personalised, more seamless and more preventative – healthcare service we all want to see but there are considerable risks that this chance may be lost in 2023 given the current cost of living and post Covid headwinds.
The report notes that integration is not a goal in itself but the way to deliver better NHS and care services. Similarly devolution is not a goal in itself but a necessity in order to deliver integration. Attendees made clear that all sectors look forward to helping make ICSs ‘bed down’ and work in 2023. they called for an accountability framework that maps to all four aims of ICSs and some went as far as to say that there should be a moratorium on any further NHS re-organisation for at least 10 years.
See below for specific recommendations. See here for tweets and retweets for articles in HSJ.
Following the Commission’s report Levelling Up Health – prepared in response to the Government’s White Paper and profiled in an MJ article here – efforts were made to achieve a series of changes to the Health and Care Bill in the House of Commons and House of Lords, prompting this letter from Lord Argar.
The Health Devolution Commission has continued in 2022 to advocate for a devolved approach to healthcare delivery and accountability. Our agreed work programme looks to develop good practice on, and promote, best practice on certain key issues amongst Integrated Care Systems as they are statutorily established in July this year. Read our press release about the launch of our work in 2022.
After the first roundtable in April – a recording of which can be found here – a summary report was prepared and an article placed in MJ – Taking Integrated Care Systems to the Next Level.
In advance of the second roundtable in June a background briefing was prepared which provides key information on the issues of Health Inequalities, Children and Young People, Mental Health and Learning Disabilities. A recording of the June roundtable, starting with Professor Michael Marmot’s contribution, is here. The slides presented by the Shelford Group, The Association of Directors of Children’s Services, Barnardo’s, Mencap and the LGA are also available. See here for the MJ’s news article after the session and click here for the Secretariat’s report of proceedings including the twelve emerging recommendations for future Integrated Care System best practice.
In advance of the third roundtable in October, a background briefing was prepared which provided key information on the issues of workforce, place-based partnerships and regulation. An update on policy and political developments was also circulated. The recording of the roundtable chaired by Norman Lamb is here along with the slides by Ofsted . See here for the MJ’s news article after the session, here for the one by HSJ and here for the Secretariat’s follow up report with fifteen key conclusions.