Independent review of ICSs launched by government

The UK Government is looking to improve health outcomes across England with the announcement of a new independent review of integrated care systems (ICSs).

According to the Department of Health and Social Care (DHSC), the ICS review will explore how best to cut through red tape and boost efficiency, financial accountability, and autonomy, with fewer national targets.

The review will be led by former Health Secretary the Rt Hon Patricia Hewitt, who is currently Chair of NHS Norfolk and Waveney Integrated Care Board (ICB). It will explore how to empower local leaders to focus on improving outcomes for their populations.

This includes giving them greater control and making them more accountable for performance and spending, reducing the number of national targets, enhancing patient choice, and making the healthcare system more transparent.

Health and Social Care Secretary Steve Barclay said: “I’m focused on supporting the health and care system through what we know will be a challenging winter but also crucially making the changes that will better prepare us for the future.

“Rather than a one-size-fits-all approach dictated from a ministerial office, local leaders are best placed to make decisions about their local populations and I want to empower them to find innovative solutions to tackle problems and improve care for patients.

“Fewer top-down national targets and greater transparency will help us deliver this aim and I am grateful to Patricia Hewitt for agreeing to lead this vital review to help us get this right. I look forward to reviewing her findings.”

The Health and Care Act established 42 ICSs across England in law on 1 July 2022. These systems are designed to bring NHS organisations and councils together locally to improve population health outcomes, break down traditional barriers for patients when accessing health and social care, and pool budgets for more effective solutions.

The independent ICS review will consider the scope for a smaller number of national targets to empower local health and care leaders and enable greater autonomy, so they have the time and resource to focus on innovating and tackling local challenges and priorities. It will also look at how local performance could be better monitored and any local targets set, with a focus on transparency.

Additionally, the review will look into how to ensure new ICSs are held robustly to account, both locally and nationally. Finally, it will investigate the relationship between ICSs, and central bodies, such as NHS England and the Care Quality Commission (CQC), as well as the CQC’s role in oversight of ICSs.

An interim report is expected before the end of the year, with a final report in the new year, which will inform the NHS’ objectives and planning.

The review will draw upon the expertise of ICS leaders, NHS England, and other experts including in academia, government, and relevant thinktanks, as well as local government, voluntary sector, and patient representatives.

Rt Hon Patricia Hewitt, Chair of NHS Norfolk and Waveney Integrated Care Board, added: “I am delighted to have been asked to lead this review of how integrated care systems can best be empowered and supported to succeed.

“By bringing together local government, the NHS and the voluntary, community and social enterprise sector, ICSs provide the biggest opportunity in a generation to improve health outcomes, transform health and care services and reduce health inequalities. Despite the many challenges we face, I am excited by how much has already been achieved in many different systems, including in Norfolk and Waveney, and optimistic about what our partnerships can do in future as we respond to the different needs of our own communities.

“This review will focus on how national policy and regulation can most effectively support and enable local systems to solve problems locally. It will build on the welcome work already done by NHS England to develop a new operating model.

“I look forward to working with colleagues from all 42 ICSs as well as the Department of Health and Social Care, NHS England, colleagues in local government and others as we respond to the Health Secretary’s and the Chancellor’s invitation to help create a system of regulation and accountability based on the principle that change should be locally led and nationally enabled.”

In May 2022, the Good Governance Institute, Care England, and the Homecare Association published a whitepaper that outlined important plans for engaging adult social care in ICSs. It recommended that ICSs should develop a plan about how to engage with adult social care providers and involve them in the care planning process.