The journey to integrated care systems in every area

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 2014, the NHS set out a widely supported vision for the future, describing the need for “triple integration” between hospitals and GPs, the NHS and social care, physical and mental health, and kicked off vanguard projects around the country.

In 2016, the NHS England asked all parts of England to begin planning together in new partnership formed of all NHS organisations, local government and others, setting out their early thinking and working with partners to develop them.

In 2018, it named the most advanced parts of the country as the first integrated care systems, with NHS England working closely with them to pioneer best practice.

In 2019 the NHS Long-Term Plan set the ambition for all parts of the country to become integrated care systems by April 2021 – “the biggest national move to integrated care of any major western country”

In 2019, NHS England recommended that government unblock legislative barriers to integrated care following a major engagement exercise to identify consensus across the health and care system.

In 2020, the COVID-19 pandemic accelerated integrated working as health and care leaders joined forces to support people at risk, offer each other mutual aid, and deliver the vaccine programme.

In November 2020, the NHS set out next steps for creating strong integrated care systems in every part of the country and launched an engagement exercise on enhanced proposals for creating statutory ICSs.

In January 2021, the NHS confirmed its legislative recommendation to government – making important adjustments to reflect feedback from local government in particular – and the government took this forward in its White Paper in February.

In April 2021, Sir Simon Stevens announced that all 42 parts of England had been declared integrated care systems.

In July 2021, the government was set to publish legislation proposing statutory ICSs for Parliament to consider, with implementation set for April 2022.

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.