What are integrated care systems?

Integrated care is about giving people the support they need, joined up across local councils, the NHS, and other partners. It removes traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services. In the past, these divisions have meant that too many people experienced disjointed care.

Integrated care systems (ICSs) are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.

Since 2018, they have been deepening the relationship in many areas between the NHS, local councils and other important strategic partners such as the voluntary, community and social enterprise sector. They have developed better and more convenient services, invested in keeping people healthy and out of hospital and set shared priorities for the future.

The NHS Long Term Plan confirmed that all parts of England would be served by an integrated care system from April 2021, building on the lessons of the earliest systems and the achievements of earlier work through sustainability and transformation partnerships and vanguards.

With each part of the country now ready to function as an ICS, NHS England and NHS Improvement has asked the Government and Parliament to establish ICSs in law and to remove legal barriers to integrated care for patients and communities. Decisions on legislation will now be for Government and Parliament to make.

Legislative change is just one way we want to realise our vision of how ICSs should work in future, and reflects many conversations we have had about this during the past few years with those who use and work in our services, local leaders and other important stakeholders.

An important part of our vision is that decisions about how services are arranged should be made as closely as possible to those who use them. For most people their day-to-day health and care needs will be met locally in the town or district where they live or work. Partnership in these ‘places’ is therefore an important building block of integration, often in line with long-established local authority boundaries.

But one of the strengths of the system is that arrangements can be adapted to reflect what makes sense locally.

We are recommending that these place-based partnerships be supported by a statutory NHS ICS body to oversee NHS functions across the whole system, and a statutory health and care partnership made up of a wider group of organisations that would bring together a wider group of partners to develop overarching plans across health, social care and public health.

We want to support ICSs with a decision-making process about how healthcare services are arranged that fits more neatly with this integrated, collaborative approach. As part of this, we recently published a consultation on our proposals for a new approach to arranging services – the Provider Selection Regime – which should make it easier to develop stable collaboration and to reduce some of the costs associated with the current procurement rules.