The Hewitt Review: An independent review of integrated care systems (4 April 2023)

Summary

On 1 July 2022, Integrated care systems (ICSs) were placed on a statutory footing. ICSs are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area.

Following their introduction, on the 18 November 2022, the Government announced that it would commission an independent review into the oversight of ICSs, considering how to best enable them to succeed, balancing greater autonomy and robust accountability, to be led by former Secretary of State for Health, the Rt Hon Patricia Hewitt. This report sets out the findings of this review.

Content

The review identifies 6 principles that it argues will help to create the context in which ICSs can thrive and deliver:

1.  Collaboration within and between systems and national bodies.
2. A limited number of shared priorities.
3. Allowing local leaders the space and time to lead.
4. The right support.
5. Balancing freedom with accountability.
6. Enabling access to timely, transparent and high-quality data.

 The report states that:

•  Delivering on these principles will require a genuine change in how the health and care system operates and a shift of resources, with the share total NHS budgets at ICS level going towards prevention needing to be increased by at least 1% over the next 5 years.
• National and regional organisations should support ICSs in becoming ‘self improving systems’, given the time and space to lead - with national government and NHS England significantly reducing the number of national targets, with no more than 10 national priorities.
• For every ICS, increased transparency is vital to enabling local autonomy. The availability of timely, transparent and high-quality data must be a priority, and NHS England and the Department of Health and Social Care (DHSC) should incentivise the flow and quality of data between providers and systems.
• To support ICSs work the government should produce a complementary strategy for the social care workforce. It also states that more should also be done to enable flexibility for health and care staff, both in moving between roles and in the delegation of some healthcare tasks
• It recommends that work should be undertaken to design a new framework for General Practice (GP) primary care contracts, as well as a review into other primary care contracts.