ICSs face irrelevance unless the devolution frenzy is curbed (HSJ, 25 April 2022)

Summary

There are too many integrated care systems (ICSs) in some parts of the country, especially the South West and Midlands, writes Alastair McLellan and Dave West in this HSJ article. This means that effective integration will struggle due to limited resources, leadership capacity and ability to influence large providers. It is also a problem widely acknowledged at the centre and within the regions. 

The proposed structure for ICSs is overly complex, consisting of a partnership board with little statutory power, which is meant to give strategic direction to an executive board which in practice will be held accountable for all decisions, but which is also meant to give up as much power and money as possible to “place based” entities which remain ill defined and have no statutory standing.