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NHS achieves key Long Term Plan commitment to roll out integrated care systems across England
Patients will have better, more joined up care as Integrated Care Systems (ICSs), which require all parts of the NHS to work with each other and their partners, are rolled out across the country from next month.
NHS chief executive Sir Simon Stevens today confirmed that the final 13 areas, serving 14.9 million people, will be formally designated “integrated care systems” (ICSs) from April 1, hitting a major milestone in the NHS Long Term Plan.
A total of 42 ICSs, which bring together hospital, community and mental health trusts, GPs and other primary care services with local authorities and other care providers will cover the whole of England.
Announcing the decision to approve the local applications from these 13 areas at a meeting of ICS leaders, NHS chief executive Sir Simon Stevens said: “Partnership working has been at the heart of the NHS’s remarkable response to the coronavirus pandemic and the NHS vaccination programme.
“Now GPs, hospitals, pharmacists, local authorities and community groups have also come together to deliver COVID jabs to more than 22 million people across England in a matter of weeks.
“We have seen what the NHS pulling together can do in the most testing period in the health service’s history.
“The establishment of ICSs across the country will help to ensure that agile approach and can-do attitude endures beyond the pandemic.”
The NHS Long Term Plan said Integrated Care Systems would be central to its delivery by bringing together local organisations to redesign care and improve population health, creating shared leadership and action.
ICSs exist to improve the health of all residents, better support people living with multiple and long term conditions, preventing illness, tackling variation in care and delivering seamless services while getting maximum impact for every pound. They bring together the NHS, local government and other organisations including the Voluntary, Community and Social Enterprise (VCSE) sectors.
While the geographical boundaries for the individual systems may evolve during 2021/22 to enable co-terminosity between the NHS and local government, the structures will enable health and care organisations to join forces and apply their collective strength to addressing their residents’ biggest health challenges, many exacerbated by COVID-19.
Health and care leaders have said this will be more important going forward as we address health inequalities and tackle issues around mental health and obesity.
The Government has set out a White Paper which will build on recommendations from NHS England and NHS Improvement to remove current legislative barriers to integration across health and social care bodies, and foster collaboration between NHS and local government organisations. This reflects the thousands of views received from every part of the health and care system and the public as part of recent engagement on what local leaders need.
Amanda Pritchard, Chief Operating Officer for NHS England and Improvement said: “This milestone is a great achievement, which shows the strength of system collaboration across the country. The ICSs have proven their value over the past year and will play an increasingly important role in the restoration, recovery and transformation of services for the benefit of patients and citizens.”
Dale Bywater, Regional Director for NHS England and Improvement in the Midlands, said: “Better joined up health and care systems mean improved, more easily accessible services for the people of the Midlands. The partnerships formed over the last four years will translate into better frontline care and we look forward to strengthening those relationships further.
“We just want to thank everyone who has worked so hard to make this a reality, especially over the last extremely challenging year.”
The 13 new ICS areas are:
- Cambridgeshire and Peterborough
- Mid and South Essex
- The Black Country and West Birmingham
- Herefordshire and Worcestershire
- Coventry and Warwickshire
- Leicester, Leicestershire and Rutland
- Shropshire, Telford and Wrekin
- Staffordshire and Stoke-on-Trent
- Cheshire and Merseyside
- Kent and Medway
ICSs, and formerly Sustainability and Transformation Partnerships, have worked for the last several years to break down barriers between organisations and improve care. Below are some recent examples of their successes:
The Black Country and West Birmingham
Partners in The Black Country and West Birmingham system launched a suite of digital innovation for patients during the COVID-19 pandemic hugely accelerating their work to increase digital inclusion.
As well as virtual clinics and GP appointments they started direct access booking into 111, remote monitoring of patients in care homes and in their own homes, pulse oximetry at home, virtual wards and reducing direct contact in care homes. Over 2000 patients have already benefited.
The system is now focusing on eliminating digital inequality with a triple aim: to address access to kit, access to connectivity and access to skills. The ICS has co-designed with the West Midlands colleges, an accredited course in using digital apps for the public, they are working with tech companies to recycle and gift IT kit and are working with telecommunication companies to gift unused data to those who need it in their communities.
Greater Manchester’s Mental Health In Education programme has introduced ten new mental health support teams in four areas and extended support through VCSE partners to schools and colleges across six areas; it is now supporting 200 schools with more than 80 new posts. It’s helped 2,000 plus students with their move to college, work and university through many activities including a virtual reality experience for young people with autism, pyramid training clubs for shy, anxious, withdrawn or quiet young people who struggle with friendships and a Drop-In Hub for new students with identified mental health. 1,000 college staff now have trauma informed training and more than 81 per cent of colleges are providing mental health and wellbeing support.
Latest data shows 45 per cent of children and young people with a diagnosable mental health condition (26,620) have been seen by an NHS-funded mental health service – up more than 10 per cent since September 2018. Greater Manchester Health and Social Care partners have invested £74m in mental health services for children and young people since 2017.
Patients in Dorset with COVID-19 were helped to use oximeters to be able to monitor their oxygen levels. Partners from across the system worked together to develop a virtual team, making the service as accessible as possible. Using the home monitored data the team – including doctors and nurses at the GP, urgent care services and the hospital – were able to advise patients quickly on whether they needed hospital care or could be managed at home. Using a similar approach, blood pressure and conditions such as COPD and diabetes are being monitored by patients at home thanks to teams from partners across the integrated care system joining together to redesign a digital and personalised care for these conditions – safer for patients during the pandemic and making use of all the resources available. Other frequent users of services can access different support such as advice on issues with housing, equipment, referral to mental health services or wider problems like isolation. The teams also use a ‘virtual ward’ approach for frail older people, with GPs, consultants, physios and social care staff monitoring their conditions and intervening as soon as possible to keep people well and independent. In 18 months, the proactive integrated response has seen Weymouth and Bridport reduce unplanned admissions to Dorset County Hospital giving it the lowest rate of the country’s three hospitals.
Cheshire and Merseyside
Twenty per cent fewer parents with young children went to A&E for basic advice only, after health and care partners in the region launched a free app to help parents.
The free ‘CATCH’ app, developed by the local council and CCGs in Cheshire, gives parents the confidence to know when medical treatment is required or when self-care would be a better option. In a survey of app users, 47 per cent said they had chosen self-care instead of attending A&E since downloading the app, while 35 per cent said it had helped them feel more confident in self-caring for their child and in knowing where to find the best treatment. Over winter 2016/17, the number of children aged 0-5 who had been discharged from A&E with basic information and advice only, had reduced by 22 per cent since the previous year.