Search the hub
Showing results for tags 'Integrated Care System (ICS)'.
-
News Article
ICS cancels four urgent treatment centre contracts after performance concerns
Patient_Safety_Learning posted a news article in News
An integrated care system has terminated a private provider’s contract to run four urgent treatment centres following performance concerns. Two local acute trusts were expected to take over from provider Greenbrook Healthcare this week, following the decision by North West London ICS. The impacted sites include Hillingdon UTC, which is co-located with the Hillingdon Hospitals Foundation Trust, as well as the Ealing, Central Middlesex and Northwick Park sites that are near to the respective hospitals run by London North West University Healthcare Trust. Read full article (paywalled) Source: HSJ, 24 January 2023 -
News ArticleAn ICS chief has said the NHS workforce crisis is not the result of a ‘funding issue’ but caused by an inefficient use of resources. Patricia Miller, chief executive of Dorset Integrated Care Board, told a board meeting on Thursday that “constantly talking about the NHS needing more money” was undermining leaders’ case to government. She said: “We have got a workforce issue in the NHS, there is no doubt about that. I don’t actually believe we have got a funding issue. We just don’t use our resources very efficiently and I don’t think we do our case any positive favour with government when we’re constantly talking about the NHS needing more money when we can’t demonstrate that what we do is efficient. “So I don’t actually accept we’ve got a funding issue unless we start to work at the optimum and then we can absolutely demonstrate that. “I think what this comes down to is that our systems are too complicated and that starts at the centre, where every initiative we have is not about redesigning service models end-to-end but about layering on different solutions to different ends of the pathway and it just makes it more complicated. “I’ve no doubt that we’ve probably got 50-plus entrance and exit points to our urgent emergency care service, it’s ridiculous. I can’t navigate my way around 50 or 60, so there’s no way a patient can do it.” Read full story (paywalled) Source: HSJ, 6 January 2023
-
News ArticleSome 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. Read full story Source: HSJ, 30 December 2022
- Posted
-
- Integrated Care System (ICS)
- Organisational Performance
- (and 1 more)
-
News ArticleThe government could scrap a number of NHS targets after a review of the health service, it has been reported. Chancellor Jeremy Hunt and health secretary Steve Barclay commissioned Patricia Hewitt, a former Labour health secretary, last month to review how the NHS’s new integrated care systems should work, as well as how the health service should work to “empower local leaders”, giving them more autonomy. According to the i newspaper, the government could abolish a majority of health service targets as a result of the review, so it can be run along similar lines to schools. Ms Hewitt is set to publish her review next spring. The newspaper said ministers believe the NHS has become “overly centralised”, with doctors and trusts having to meet many different targets - more than 70 for GPs - and forced to tailor their work to meet them. Instead, the government would rather run the NHS “more like we do the schools system”, a senior government source told the i, giving local leaders increased responsibility on how to effectively meet NHS goals. The idea of fewer targets was received positively by the Royal College of GPs, which described many of the targets as “tick box exercises”. Professor Kamila Hawthorne, chair of the Royal College of GPs, told the newspaper that GPs are working under “intense workload” and pressure, with a “bureaucratic burden” adding to their workload. Read full story Source: The Independent, 26 December 2022
- Posted
-
- Organisation / service factors
- Leadership
- (and 1 more)
-
News ArticleThe current GP funding model ‘does not sit comfortably’ with NHS England’s plans for primary and community care integration, according to a senior NHS England director. In a Lords Committee hearing today, NHS England’s national director of primary and community care services Dr Amanda Doyle said a ‘rethink’ was required with regards to the primary care estate, with Integrated Care Boards (ICBs) tasked to draw up local plans. Asked whether the GP partnership model was compatible with integration, Dr Doyle told the committee that this was ‘one of the challenges’ they are facing. She said: "One of the challenges that the current predominant ownership model in general practice gives us is that both investment and revenue flows support that model [of] an individual, practice-sized building. "And lots of the things we want to do as we move forward into co-located primary care services and scaled-up primary care delivery drive the need for bigger premises with a wider range of capacity, and those two models don’t sit comfortably together." Read full story Source: Pulse, 19 June 2023
-
News Article
‘Get stuck into ICSs’, Hewitt tells local leaders
Patient Safety Learning posted a news article in News
NHS leaders ‘who might be hesitating about whether or not to really commit’ to their local integrated care system should ‘put aside all of those doubts [and] get stuck in’, Patricia Hewitt has claimed. Ms Hewitt, Norfolk and Waveney Integrated Care Board chair and former health secretary, was speaking at the NHS ConfedExpo conference, the day after government responded to her recent review of ICSs. The Department of Health and Social Care rejected or ducked several of its most eye-catching recommendations, but did state its support for ICSs and system working; while Labour has also said it would maintain ICSs should it come to power. Ms Hewitt said the government response was more positive than she had feared at some points, and it “would have been a complete miracle” if ministers had backed all her recommendations. Read full story (paywalled) Source: HSJ, 15 June 2023 -
News Article
We need to be ‘really thoughtful’ about intervening with ICSs
Patient Safety Learning posted a news article in News
NHS England needs to be ‘really thoughtful’ about how and when it intervenes as powers are devolved from the centre to integrated care systems, NHSE’s chief executive has said. Following her keynote speech at NHS ConfedExpo in Manchester today, Amanda Pritchard was asked about “her vision for the future” devolving powers to Integrated Care Systems (ICSs) as part of the NHS reforms and if “it changes the way leaders should behave”. Ms Pritchard admitted “earned autonomy” in relation to ICSs – a phrase she has previously used but has jarred with many local leaders – was “not quite the right phrase”. “It feels like we’re using yesterday’s language for today’s ways of working. I know it’s not quite the right word, but I can’t think of a better one at the moment,” she said. “What I am asking my own organisation to do, is make sure that we are really thoughtful about all of those different things that we do, and we are increasingly really intentional about which of those [tools] you can use in different circumstances [in regards to performance and accountability].” Read full story Source: HSJ, 14 June 2023 -
News Article
ICSs most ‘off target’ on recovery named by NHS England
Patient Safety Learning posted a news article in News
Seven integrated care systems and one ambulance trust have been placed in ‘intensive support’ because of their performance against urgent and emergency care metrics. NHS England launched the new intervention regime for emergency care earlier this year to measure progress against the urgent and emergency care recovery plan. The most troubled systems and organisations are now placed in a first “tier” and will receive central support from NHSE. Other systems requiring support from NHSE regional teams are placed in a secondary tier. This tiered approach is already in place for cancer and elective performance. Support will include help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. Read full story (paywalled) Source: HSJ, 7 June 2023- Posted
-
- Integrated Care System (ICS)
- Organisational Performance
- (and 2 more)
-
News ArticleMultiple problems have been highlighted with the leadership and governance of a much-vaunted integrated care system, including a lack of trust between organisations which often hide information that could weaken their position. HSJ has seen an executive summary of the review of Greater Manchester ICS, which cited widespread concerns around the allocation of resources, confusion about the role of commissioning, and “muddled” governance, including: a lack of transparency and trust between partners, with some only sharing a “partial overview” of performance and finances which drives choices likely to “bias” some organisations; complex architecture of system boards, committees and forums, with “muddled” governance, unclear paths for critical decisions to be made, and unclear delegations to localities; frustration at the quantum of meetings that take place at system, locality and provider level. Read full story (paywalled) Source: HSJ, 2 June 2023
-
News ArticleAn integrated care board (ICB) has advised its GP practices not to give patients automatic access to their records, contradicting NHS England national requirements. Instead, North East London ICB has suggested practices only allow access where patients request it, and subject to conditions. The national go-live date for patients to be allowed automatic access to future entries in their records has been repeatedly delayed since initially being set at December 2021. GPs have argued they needed more time to redact sensitive information, ensure records are not inappropriately shared, and train staff. They have cited workload and safeguarding concerns. The ICB’s chief clinical information officer Osman Bhatti, who is a GP, told HSJ the ICB instead “wanted a process where patients could access both prospective and retrospective records safely, with less workload for GPs and so patients who actually want access can have it”. Read full story (paywalled) Source: HSJ. 1 June 2023
- Posted
-
- Integrated Care System (ICS)
- Electronic Health Record
- (and 2 more)
-
News Article
ICB sends trust five safety warnings in six weeks
Patient Safety Learning posted a news article in News
An integrated care board (ICB) has sent multiple warnings to a local trust highlighting ‘serious issues’ with the safety and quality of care provided. East Kent Hospitals University Foundation Trust had had severe and widely reported issues in its maternity services but the five emails and letters from Kent and Medway ICB, sent across a six-week period in February and March, flagged concerns extending into other parts of the organisation. These included: Serious incidents had “recurrent themes” and there was a “lack of evidence the trust is learning” from them. A spot audit had revealed more than one in five patients at the Queen Elizabeth The Queen Mother Hospital in Thanet had overdue modified early warning scores, which can show if a patient is deteriorating. Further concerns about adult safeguarding “have been raised in relation to 18 allegations of abuse against people in positions of trust” despite the provider implementing a review on the issue 18 months earlier. Read full story (paywalled) Source: HSJ, 22 May 2023 -
News ArticleICBs should ensure there are ‘formal escalation routes’ in place for GPs after 25 daily clinical contacts, the BMA has said in new guidance. From next week (15 May), GP practices are contractually required to offer an ‘appropriate response’ to patients the first time they get in contact, by offering them an appointment or redirection, rather than asking them to call back at a different time. While GP leaders warned this would lead to increased pressure on NHS 111 and A&E, NHS England attempted to clarify in this week’s recovery plan that GPs should only redirect patients in ‘exceptional circumstances’. It also said practices should inform their ICB on each such occasion. However, conflicting BMA guidance has now been published, warning that practices attempting to adhere to the new requirement ‘may do so at the expense of clinician wellbeing and patient safety’. It reiterates the GP Committee for England’s safe working guidance recommending that clinicians have no more than 25 clinical contacts per day because anything beyond this "can lead to decision fatigue, clinical errors and patient harm, and clinician burn out". Read full story Source: Pulse, 11 May 2023
- Posted
-
- Integrated Care System (ICS)
- GP
- (and 4 more)
-
News Article
Six systems pulled up by NHSE over poor cancer diagnosis performance
Patient Safety Learning posted a news article in News
NHS England has demanded recovery plans from six systems with a poor record on delivering urgent cancer checks. NHS England has told the chief executives of the six integrated care boards they must “present and deliver a plan” to make more use of their diagnostic facilities for patients who need urgent cancer checks. The “facilities” referred to are all community diagnostic centres. The six were selected because they diagnosed or ruled out fewer than 70% of urgent cancer referrals within 28 days during February. This benchmark is known as the “faster diagnostic standard”. A letter to the chief executives said: “improving waiting times for patients referred for urgent suspected cancer will be a critical priority for the NHS over the coming year”. It adds: “it is essential… our national investments in diagnostic capacity are more clearly prioritised for patients being investigated for urgent suspected cancer”. Read full story (paywalled) Source: HSJ, 28 April 2023- Posted
-
- Organisational Performance
- Integrated Care System (ICS)
- (and 3 more)
-
News Article
‘National improvement board’ to be set up by NHS England
Patient Safety Learning posted a news article in News
NHS England has launched a new framework for quality improvement and delivery, including a national board that will pick a “small number of shared national priorities”. The new document says NHSE will “establish a national improvement board, to agree the small number of shared national priorities on which NHS England, with providers and systems, will focus our improvement-led delivery work”. The review says NHSE will, among other actions: Create a “national improvement board” to “agree a small number of shared national priorities and oversee the development and quality assure the impact of the NHS improvement approach”. Set an expectation that all NHS providers, working in partnership with integrated care boards, will embed a quality improvement method aligned with the NHS improvement approach”. Incentivise a universal focus on embedding and sustaining improvement practice”, including with “regulatory incentives alongside clearer and more timely offers of support. Work with the [Care Quality Commission] to align the revised CQC well-led [inspection method] with the improvement approach. Read full story (paywalled) Source: HSJ, 21 April 2023- Posted
-
- Quality improvement
- Organisation / service factors
- (and 3 more)
-
News Article
Fury greets cuts to funding for social care’s contribution to integration
Patient-Safety-Learning posted a news article in News
Confirmation the government has cut hundreds of millions from budgets partly designed to boost health and care integration has been met with fury, with the decision described as leaving the social care reform agenda in ‘tatters’. It was revealed last month that the £1.7bn promised in 2021’s social care white paper to strengthen the sector, and especially its contribution to more integrated services, was set to be drastically cut by ministers. Today’s announcement has confirmed the investment originally ear-marked for “investment in knowledge, skills, health and wellbeing, and recruitment policies [to] improve social care as a long-term career choice” has been cut from £500m to £250m, the £300m promised to “integrate housing into local health and care strategies" cut to zero. The white paper also promised “at least £150m” for investment in digital and technology, but today’s government announcement has capped this at £100m. Overall cuts to the series of reform programme are in the region of £600m. Only £520m has been allocated, and it is unclear where the rest of the original £1.7bn will be spent. Sarah McClinton, president of the Association of Directors of Adult Social Services, said the plan “takes us backwards” and “leaves the government’s vision for reform in tatters”, adding that it “ducks the hard decisions and kicks the can down the road again until after the next election.” Read full story (paywalled) Source: HSJ, 4 April 2023- Posted
-
- Social care
- Funding
-
(and 1 more)
Tagged with:
-
News Article
CQC’s ICS ratings put on hold
Patient Safety Learning posted a news article in News
Plans for integrated care systems (ICSs) to be given Care Quality Commission (CQC) ratings are on hold, and no ratings will be issued until summer 2024 at the earliest, HSJ understands. The government had previously said ICSs would be given ratings – after pressure from Jeremy Hunt, then Commons health committee chair and now chancellor – and there was an expectation the process would begin next month. However, while legislation says the CQC will review and assess ICSs, it does not require it to give ratings. HSJ understands the Department of Health and Social Care supports the CQC beginning early work on assessing ICSs shortly, but does not plan to sign off on ratings being issued, nor set any date for that to happen. It means that, at the very earliest, more detailed reviews leading to ratings could happen from spring/summer 2024. One source with knowledge of the decision said there was not strong support for ratings work to start, and the CQC still needed to do a lot of work to adapt its approach to ICSs. Read full story (paywalled) Source: HSJ, 27 March 2023- Posted
-
- Integrated Care System (ICS)
- Organisational Performance
- (and 1 more)
-
Content ArticleSystem working (which includes health and care) is the only way the NHS can address the interlinked problems of struggling primary care, elective backlog, ambulance and emergency department overload, and delayed discharge. In this HSJ article, Len Richards explains how system working grows from the right culture, clinical leadership and systemwide joined up, real-time data.
- Posted
-
- Collaboration
- System safety
- (and 6 more)
-
Content ArticleIntegrated care systems are now legally responsible for leading a localised approach that brings multiple aspects of the healthcare system closer together, and for working better with social care and other public services. However, this is not a new aspiration, so why should it be any different this time? The Nuffield Trust hosted a series of roundtables to discuss concerns with stakeholders and experts to try and understand how to ensure the aims are achieved. This report summarises these findings and offers ways forward as the new era gets underway.
- Posted
-
- Clinical governance
- Leadership
- (and 4 more)
-
Content ArticleThis recording is of the launch of the Health Equity Network (HEN) on 24 January 2023. The HEN aims to roll out practical solutions to reduce health inequalities, and will help organisations and individuals across the public, private and third sectors to connect and collaborate with those working towards similar health equity goals. It will offer opportunities to share work and knowledge and for members to engage with others across the country. Speakers at the event included: Dr. Jessica Allen, Deputy Director of The Institute for Health Equity Dr. Henry Kippin, Managing Director of the North of Tyne Combined Authority Pete Gladwell, Group Social Impact and Investment Director, Legal & General Capital Alan Higgins, Health Equity Network Lead Professor Sir Michael Marmot, Director of the Institute of Health Equity Sign up to join the Health Equity Network online community
- Posted
-
- Health inequalities
- Health Disparities
- (and 5 more)
-
Content ArticleIn this blog, Jonathan Back, Intelligence Analyst at the Healthcare Safety Investigation Branch (HSIB), looks at the opportunities the healthcare system has to adopt proactive risk management to improve patient safety. He highlights that understanding the value of different perspectives may provide new opportunities for improvement if applied across the health and care system. He also outlines the role of the new integrated care boards (ICBs) in achieving this whole-system approach, which should include a clinical governance perspective, organisational and local system perspective and societal perspective.
- Posted
-
- Risk management
- Clinical governance
- (and 3 more)
-
Content ArticleLetter from Sir David Sloman Chief, Operating Officer NHS England, Professor Sir Stephen Powis, National Medical Director NHS England, and Dame Ruth May, Chief Nursing Officer, to ICBs and Trusts regarding the upcoming ambulance industrial action.
- Posted
-
- Workforce management
- Ambulance
- (and 5 more)
-
Content ArticleKeeping patients safe during their care and treatment should be at the heart of any health system, including the NHS. Yet avoidable harm still occurs every day, around the world. There have been major efforts to prioritise patient safety in England, but the pandemic has shone a light on areas of care where progress has stalled, or safety has deteriorated. This report by Imperial College London's Institute of Global Health Innovation, commissioned by Patient Safety Watch, brings together publicly available data to present a national picture of patient safety in England.
- Posted
- 1 comment
-
- Patient harmed
- Recommendations
- (and 9 more)
-
News Article
Six ICS chiefs to lead regional decision-making group
Patient Safety Learning posted a news article in News
Six integrated care boards across the West Midlands are proposing to establish a joint committee of chief executives to make shared decisions on key issues impacting the region, it has emerged. The CEOs of Shropshire, Telford and Wrekin ICS, Black Country integrated care systems, Birmingham and Solihull ICS, Herefordshire and Worcestershire ICS, Coventry and Warwickshire ICS and Staffordshire and Stoke-on-Trent ICS have each presented plans for a senior joint committee of the ICBs in their respective board papers. Chiefs say there are several areas where it will be “beneficial or necessary” for the six ICBs to collaborate and make joint decisions, and it is intended this committee will provide such a mechanism. HSJ understands it could also act as a forum to discuss performance. Proposed shared areas of action include primary care and specialised services, which ICBs will be responsible for from April 2023, commissioning for 111/999 services, mutual aid on elective/cancer recovery, and urgent and emergency care, including ambulance handover delays. According to draft terms of reference, an executive committee of CEOs would be accountable to the six ICB boards and would be required to report all decisions, actions and progress to their respective systems. Read full story (paywalled) Source: HSJ, 7 October 2022- Posted
-
- Integrated Care System (ICS)
- Decision making
- (and 2 more)
-
News Article
Trusts ‘rationing’ crisis support as only seven ICSs achieve service expansion
Patient Safety Learning posted a news article in News
Only a handful of integrated care systems have so far managed to implement a key expansion in their support for patients in mental health crisis. Internal NHS England documents, seen by HSJ, suggest that only 7 out of 42 health systems have begun offering enhanced mental health crisis support through the 111 helpline. This was a key target set out by the NHS long term plan in 2019, to be fully rolled out by next year. Some areas of the country have implemented the expansion, but others are lagging well behind, the document suggests. Currently, all areas offer separate 24/7 all-age crisis lines run by individual mental health trusts, offering brief psychological interventions and advice. But HSJ has been told of national problems affecting the existing helplines, with callers facing long waits. In a recent review, Healthwatch England said the services are having to “pick and choose” who to help because of high demand, which in effect led to “service rationing”. Siân Balsom manager for Healthwatch York, said: “People are overwhelmingly positive about the NHS. But there’s an acceptance that crisis support is not going to be there for people. That feels like a really bad place to be in. “We know people in the voluntary sector feel like they are holding people they don’t have the skills and experience to support. [They] feel they are holding people in the wrong service because the right service is not there for them. “People are trying to do a good job, but the system is more under pressure than it has ever been and there are clearly a lot of people who are experiencing significant mental illness who are not able to get support right there and then.” Read full story (paywalled) Source: HSJ, 3 October 2022- Posted
-
- Lack of resources
- Organisation / service factors
- (and 2 more)