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Some ICSs need ‘an awful lot of central control', says Hewitt

Some integrated care systems (ICSs) still require “an awful lot of control” from the centre, Patricia Hewitt has told HSJ, tempering any expectations that her government-commissioned review will bring about a wholesale roll-back of national performance management.

The former Labour health secretary, who is also an integrated care board chair, was commissioned in November by chancellor Jeremy Hunt and health secretary Steve Barclay to review ICS autonomy and accountability.

In her first interview since she started the work, Ms Hewitt also said: 

  • She had not ruled out “legislative tweaks” as a result of her review, but emphasised ICBs already had substantial ”soft power”;
  • Some ICBs were still indulging in ‘old school’ combative behaviour, and stressed they should not become ‘top down regulators’;
  • She wanted to “catalyse” the Care Quality Commission’s move to focus on systems and integration; and
  • It appeared there were probably too many non-clinical support staff in the NHS, but not too many managers, and she would look more closely at the issue.

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Source: HSJ, 30 December 2022


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