Integrated care systems: what do they look like? (The Health Foundation, 15 June 2022)

Summary

The NHS in England is about to be reorganised. In April 2022, government passed the Health and Care Act 2022 – the biggest legislative overhaul of the NHS in a decade.

The centrepiece of the legislation are integrated care systems (ICSs) – area-based agencies responsible for planning local services to improve health and reduce inequalities. From July 2022, England will be formally divided into 42 ICSs, covering populations of around 500,000 to 3 million people. ICSs have existed informally since 2016, but – until now – lacked formal powers.

ICSs face a mammoth task. Staffing shortages in the NHS are chronic, record numbers of people are waiting for routine hospital treatment, and health inequalities in England are wide and growing. But these challenges are not evenly distributed between ICSs – and some systems are better equipped to deal with them than others. Policymakers have allowed some flexibility in how local systems have been developed and organised, which means they vary widely in size, structure, and other characteristics.

In this long read, The Health Foundation analyses publicly available data on some of the characteristics of ICSs and context in each area – including the organisational and policy context, health challenges, and capacity within the health care system to address them. It compares areas and discusses implications for policy.