The Health and Social Care committee’s report into new
partnerships aimed at delivering joined-up health and care
services is calling for the Government and NHS England to address
key concerns if an opportunity to deliver real change is to be
realised.
The inquiry, with a focus on
autonomy and accountability, found genuine enthusiasm for the
potential of ICSs to deliver on challenges facing the health and
care sectors. However, MPs warn of a serious lack of clarity in
some areas with risks that acute short-term pressures could be
given priority over longer term ambitions such as preventing
ill-health.
MPs also express concern that the success of the restructuring
programme could be jeopardised if NHS England continued to take a
“command and control” approach. The Report says it is vital that
the Government and NHS England should not dictate how ICSs
deliver local outcomes.
The restructuring programme established 42 Integrated Care
Systems in England that came into force in July 2022.
Chair of the Health and Social Care Committee said:
“This is a key moment for Ministers and for NHS England. We have
found genuine enthusiasm for the potential of Integrated Care
Systems to make a real change, not only in how health and social
care is delivered but in prioritising the needs of local
populations and preventing ill-health.
“It would be an opportunity lost if that success was undermined
by the need to prioritise central government targets or a focus
on meeting short-term demands. We urge Ministers not to lose
sight of the crucially important prevention agenda and we call
for them to adopt a light-touch outcome driven approach to this
new way of working.
“We were pleased that the Government commissioned the Hewitt
Review, considering similar themes to our own inquiry, and
welcome the spotlight that is being shone on ICSs at this early
stage in their development. We hope to see this focus maintained
and look forward to considering the Review’s findings.”
ENDS
Key recommendations to Government/NHS
England:
· Targets for ICSs set by
DHSC and NHS England should be based on outcomes, greater
prescription around how targets are achieved should be done
sparingly.
· Any update to NHS England's
Long-Term Plan must put prevention and long-term transformation
at its heart.
· Integrated Care Boards
should ensure they include a public health representative, such
as a public health director or public health lead.
· DHSC should gather
information relating to the membership of ICBs and then review to
understand whether further mandating is required.
· DHSC, working with ICSs,
should set out action that could be taken to resolve issues of
poor partnership working, especially with social care.
· DHSC should urgently
provide the CQC with its decision on ratings and any priorities
it would like the CQC to focus on.
Please see attached Report for a full list of
conclusions and recommendations.
Improved outcomes in population health and healthcare are a core
purpose of ICSs, however the Report notes that public health
professionals are not mandated to sit on Integrated Care Boards,
one element of the partnership. MPs voice concern that without
this expertise, longer-term priorities will not be addressed,
fearing that the changes instead will continue ‘a sickness
service’ rather than produce a health service fit for the
future.
The Report concludes there is a clear risk that short-term, acute
pressures will dominate ICS capacity, with evidence that has
highlighted the scale of the challenge if they are to balance
immediate pressures with longer-term work.
MPs express concern that though the CQC will assume legal powers
to assess ICSs from April, the Government has failed to clarify
key aspects such as whether ratings are required and the
priorities that an assessment would be based on.
Evidence given to the Committee also raised concern about the
exclusion of adult social care in new systems and the risk of
ICSs becoming 'NHS-centric'.
Further information:
· In November the Government
announced an independent review into the oversight of Integrated
Care Boards in England and how they can best work with autonomy
and accountability, led by former Health Secretary .
