Developing more joined-up health and care has been a bottom up, step-by-step journey for the NHS and its partners, building on the expertise of frontline staff and learning from what works well in different areas.
In 2015, ‘vanguard’ sites in 50 areas took the lead in developing and testing five new models of care, aiming to provide blueprints and inspiration for the rest of the health and care system.
In 2016, NHS organisations, local councils and others came together to form sustainability and transformation partnerships in every part of England, and set out their local proposals to improve health and care. Over the next year, they refined these initial proposals, drawing on wide-ranging conversations with their NHS people, local residents and others in the community.
From 2018, some of these partnerships evolved to form even closer partnerships, through integrated care systems. In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve.
In 2019, the NHS Long Term Plan confirmed – in what it described as ‘the biggest national move to integrated care of any major western country’ – that every part of England would be served by an integrated care system from April 2021. The Plan also confirmed that primary and community services would be funded to provide a greater range of services in more convenient settings.
Since the publication of the plan, the COVID-19 pandemic presented the NHS, local councils and others with some of their biggest challenges of the past 70 years and showed that no organisation could rise to these alone. Services responded by making in days and weeks changes that were previously debated for months or years. There is an appetite across health or care systems to lock in these gains, and the new, beneficial ways of working developed in the heat of the pandemic.