The NHS and its partners will be able to ‘lock in’ improvements to their work by putting whole-system planning at the heart of coronavirus recovery plans, the NHS’s Chief Operating Officer said today.

The comments came as NHS England and NHS Improvement confirmed four new ‘integrated care systems’, together serving more than six million residents.

As part of the effort to respond to the COVID-19 health emergency, NHS and local government staff have been fast-tracking new technology, new partnerships and new ways of working, to make services easier and more convenient for residents.

Integrated care systems (ICSs) and, in other areas, sustainability and transformation partnerships have been central to the coordination and delivery of this response, bringing together hospitals, care homes, GPs and others to plan for immediate and future needs. This has included important initiatives between NHS and local government, such as mutual aid agreements.

A further four ICSs were confirmed today, joining 14 previously announced plus two devolved health systems in Greater Manchester and Surrey. Taken together, around half of England’s population is now served by such a system.

This includes the whole of Yorkshire (with the confirmation of an ICS covering Humber, Coast and Vale) and all of London south of the river Thames (with South West London joining its neighbour in South East London).

The two other partnerships confirmed today are one covering Sussex, and another in Hertfordshire and West Essex.

Highlights of recent partnership work in these areas include:

• Hospitals in Hertfordshire and West Essex are working together to build a vascular services network built around a specialist centre with vascular hub sites elsewhere. This will improve diagnosis, care quality, experience and outcomes for patients such as those who require major arterial surgery.
• Humber, Coast and Vale has developed new roles in its health and care workforce to support existing doctors, nurses and therapists and meet local need. This has included helping to train and recruit more than 300 advanced clinical practitioners, nursing associates and physician associates, who are already enabling more people to access faster care and support.
• The NHS in South West London has joined forces with 140 schools and 6 further education colleges to improve mental health support for around 80,000 pupils. The programme offers group and one-to-one work with pupils, online resources, staff training and parent workshops.
• The system covering Sussex improved performance against the national A&E four-hour target by 1.2 per cent during 2018-19 (compared to a small dip elsewhere) while improving its financial position more (at 2.4 per cent) than any other part of country.

Amanda Pritchard, Chief Operating Officer at NHS England, said: “The response to COVID-19 has touched every part of our health and care systems. We have seen our hospitals transformed, accelerated use of technology in GP surgeries, mental health services and hospital clinics, innovation in community-based services and been reminded of our interdependence with social care, and the critical role of public health. The response to the COVID-19 health emergency has been whole-system working and so must be the recovery.

“As well as locking in the improvements we want to keep, we must maintain the agility that has served the NHS so well. Changes that have been debated for years, delivered overnight with strong partnership working. We have acted our way to transformation and better care, and we must continue to do so.”

To become an ICS, each system has shown that its partners have a shared vision to improve services for its whole population now and in future, backed up by robust planning and strong collective leadership and accountability.

In areas not yet designated as integrated care systems, whole-system efforts have been overseen by sustainability and transformation partnerships, which perform a similar local leadership role while they prepare to make the transition to full ICS status by 2021, as set out in the NHS Long Term Plan.

ICSs bring together local organisations in a pragmatic and practical way to deliver the ‘triple integration’ of primary and specialist care, physical and mental health services, and health with social care. They will have a key role in working with local authorities at ‘place’ level, and through ICSs, commissioners will make shared decisions with providers on population health, service redesign and NHS Long Term Plan implementation.

Background

The Sussex figures set out above relate to the successor sustainability and transformation covering Sussex and East Surrey. The new system in Sussex serves the population covered by clinical commissioning groups (CCGs) in West Sussex, East Sussex and Brighton and Hove, while East Surrey CCG is now part of the wider Surrey health and care system.