Search the hub
Showing results for tags 'Integrated Care System (ICS)'.
Found 178 results
-
Content ArticleStructural, economic and social factors can lead to inequalities in the length of time people wait for NHS planned hospital care – such as hip or knee operations – and their experience while they wait. In 2020, after the first wave of the Covid-19 pandemic, NHS England asked NHS trusts and systems to take an inclusive approach to tackling waiting lists by disaggregating waiting times by ethnicity and deprivation to identify inequalities and to take action in response. This was an important change to how NHS organisations were asked to manage waiting lists – embedding work to tackle health inequalities into the process. Between December 2022 and June 2023, the King’s Fund undertook qualitative case studies about the implementation of this policy in three NHS trusts and their main integrated care boards (ICBs), and interviewed a range of other people about using artificial intelligence (AI) to help prioritise care. It also reviewed literature, NHS board papers and national waiting times data. The aim was to understand how the policy was being interpreted and implemented locally, and to extract learning from this. It found work was at an early stage, although there were examples of effective interventions that made appointments easier to attend, and prioritised treatment and support while waiting. Reasons for the lack of progress included a lack of clarity about the case for change, operational challenges such as poor data, cultural issues including different views about a fair approach, and a lack of accountability for the inclusive part of elective recovery. Taking an inclusive approach to tackling waiting lists should be a core part of effective waiting list management and can contribute to a more equitable health system and healthier communities. Tackling inequalities on waiting lists is also an important part of the NHS’s wider ambitions to address persistent health inequalities. But to improve the slow progress to date, NHS England, ICBs and trusts need to work with partners to make the case for change, take action and hold each other to account.
-
Content Article'Gridlock' of patients in urgent and emergency care is often attributed to a lack of onward capacity for people leaving hospital, leading to delayed discharges that back up the system. But does this explanation often favoured by government and policy makers tell the whole story? The Nuffield Trust's Quality Watch investigates whether the pattern is visible in patient journeys through urgent and emergency care at the integrated care system level.
-
Content ArticleA new report from the Public Policy Projects (PPP) calls on integrated care systems (ICSs) to harness the unique capabilities of the pharmacy sector and implement a pharmacy-led transformation of healthcare delivery. The report, Driving true value from medicines and pharmacy, is chaired by Yousaf Ahmad, ICS Chief Pharmacist and Director of Medicines Optimisation at Frimley Health and Care Integrated Care System, and is the culmination of three roundtable events attended by key stakeholders from across the pharmacy sector and ICS leadership. Insight from these roundtables has also been accepted as evidence in the Health and Care Select Committee’s recent inquiry into the future of the pharmacy sector.
-
Content ArticleGood practice guidance for integrated care boards (commissioners and providers) produced by NHS England. This community rehabilitation and reablement model, published alongside the intermediate care framework, aims to ensure that the individual (and their families) is at the centre of discussions and that any transition points will be as seamless as possible.
-
Content ArticleThe ICS Delivery Forum is a series of regional conferences hosted by Public Policy Projects. Each event convenes local ICS leadership, key health and care experts and other stakeholders including industry leaders. A series of panel discussions and case study presentations are given throughout the day. This document summarises the key insights from the Leeds ICS Delivery Forum event held in Leeds on 28 June 2023. The document placed these discussions into the broader context of health and care transformation, both at a local and national level. As such, wider sources and research are used to expand upon the key points.
-
Content ArticleThe ICS Delivery Forum is a series of regional conferences hosted by Public Policy Projects. Each event convenes local ICS leadership, key health and care experts and other stakeholders including industry leaders. A series of panel discussions and case study presentations are given throughout the day. This document summarises key insights from the Manchester ICS Delivery Forum event held on 25 May 2023. The document places these discussions into the broader context of health and care transformation, both at a local and national level, so wider sources and research are used to expand upon the key points. It looks at the following aspects of integration in Manchester: Community engagement Working with VCSE organisations Governance
-
Content ArticleThis editorial in the HSJ outlines the financial issues facing Integrated Care Systems (ICS) in England, drawing attention to deficits reported in Greater Manchester, West Yorkshire and East London. HSJ Deputy Editor Dave West highlights that neither the Government nor the opposition are keen to signal new funding adequate to deal with these funding gaps.
-
Content ArticleIt is more important than ever that Integrated Care Systems (ICS) invest urgently in community mental health. The introduction of the Community Mental Health Framework in 2019 presented a once-in-a-generation opportunity for mental health systems. With ringfenced transformation funding coming to an end in April 2024 and in a climate of crisis and uncertainty, we need to ensure these changes are embedded. Rethink Mental Illness have launched their new report, 'Building Community into the Integrated Care System; A practical guide to developing robust community mental health', where they: Summarise the significant challenges facing mental healthcare. Provide a toolkit of practical, workable solutions to common barriers to transformation. Explore the role that the VCSE sector can have in pursuing the four core aims and future goals of ICSs.
-
EventuntilThe introduction of integrated care systems (ICSs) has placed a renewed focus on how organisations can work together to integrate care to meet the needs of local populations. However, much of the activity to integrate care, improve population health and tackle inequalities will be driven by commissioners and providers collaborating over smaller geographies (often referred to as ‘places’) within ICSs. This King's Fund conference will provide an opportunity to discuss how effectively place-based care is being delivered across the health and care system, how place-based partnerships – collaborative arrangements that typically include the NHS, local government and others such as voluntary, community and social enterprise (VCSE) sector organisations and social care providers with responsibilities for planning and delivering services – are evolving, and whether more needs to be done to involve places and communities in developing local approaches to reducing health inequalities. Conference sessions will also explore how ICSs and mayoral combined authorities are developing approaches to supporting the development of healthy places in their locality. You will hear from local partners from the voluntary, community and social enterprise (VCSE) sector, local government and more widely across the health and care system about their role in developing integrated plans, healthy places and neighbourhoods. Register
-
News Article
Trusts’ row over stroke services sparks ‘significant safety’ concerns
Patient Safety Learning posted a news article in News
A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register. Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register. The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”. The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay. West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”. Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”. Read full story (paywalled) Source: HSJ, 3 October 2023 -
Content ArticleThere is widespread variation in the instance and quality of meaningful patient involvement across the 42 Integrated Care Systems (ICSs) of NHS England. This is seen throughout the structures, policies and processes of the ICSs, from the omission of patient representatives on decision-making bodies—such as Integrated Care Boards (ICBs)—to the neglect of clear consultation when decisions are made concerning a patient’s care. This report present the results of research and analysis conducted by the Medical Technology Group (MTG). It shows that where a patient lives is the biggest determinant to whether they are involved in their care meaningfully, or at all. It makes recommendations for the Government, NHS England and ICS's on the approach that should be taken to ensure meaningful patient engagement.
-
Content ArticleFour enablers of effective collaboration between integrated care systems and ambulance services.
-
News Article
Execs accused of ‘bullying culture and misuse of power’
Patient Safety Learning posted a news article in News
Former commissioning chiefs have been accused of presiding over a ‘culture of bullying’ at the predecessor organisation to Norfolk and Waveney Integrated Care Board, as part of a legal claim from a former employee. The accusations, which have been made in an employment tribunal case, relate to former chief executive Melanie Craig and other former executives at what was then Norfolk and Waveney Clinical Commissioning Group. Ms Craig now leads Suffolk Community Foundation, a local voluntary sector organisation. The claims have been made by a former long-standing assistant director for mental health services, Clive Rennie, who has claimed unfair dismissal. However, the integrated care board said it disputes the claims and is defending the case. In a witness statement to the tribunal, which began this week, Mr Rennie alleges there was an “authoritarian and dictatorial style of management” and described a “culture of bullying and misuse of power that had emerged under the leadership of Melanie Craig and which included the executive team”. Read full story (paywalled) Source: HSJ, 6 September 2023 -
Content ArticleIn 2011, the government acknowledged a large treatment gap for people with mental health conditions and sought to establish ‘parity of esteem’ between mental and physical health services. From 2016, the Department of Health & Social Care (DHSC) and NHS England made specific commitments to improve and expand NHS-funded mental health services. NHSE, working with the Department and other national health bodies, set up and led a national improvement programme to deliver these commitments. This report by the House of Commons Public Accounts Committee assesses progress made in delivering these commitments. The report acknowledges that NHS England has made progress in improving and expanding mental health services, but says this was "from a low base."
-
News ArticleProposals for primary care networks to evolve into more collaborative “integrated neighbourhood teams” to improve access to care have been broadly welcomed. A “stocktake” report commissioned by NHS England, published on 26 May, called for urgent same day appointments to be dealt with by “single, urgent care teams” for every neighbourhood with greater use of a range of health and social care professionals. The report, written by Claire Fuller, a general practitioner and chief executive of Surrey Heartlands Integrated Care System, undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looks at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems. Doctors’ leaders welcomed many of the report’s recommendations but emphasised that they could only work if the government resourced primary care practices better and tackled workforce shortages. Read full story (paywalled) Source: BMJ, 27 May 2022
-
News Article
ICS set to miss July two-year waiters target by 860 patients
Patient Safety Learning posted a news article in News
One of England’s most challenged integrated care systems (ICS) is set to miss by more than 800 patients the government’s target of eliminating two-year elective waits by July. Devon ICS currently estimates 860 patients will have waited longer than two years for planned care by July 2022, when all patients waiting longer than two years should have been treated – according to the NHS’s elective recovery plan. It is the first reported example of an ICS forecasting to miss the high-profile target which government has agreed with NHS England. The ICS, which is among the health systems with the lowest rating from NHSE, is a national outlier against the target, with around 1,500 patients currently waiting two years or more for care. The backlog has occurred despite the ICS previously being one of 12 systems given extra money for planned care through the elective accelerator programme and retaining the use of its Nightingale Hospital. Read full story (paywalled) Source: 6 May 2022 -
News Article
Patients less pleased with GP phone access in all but one ICS
Patient Safety Learning posted a news article in News
Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023 -
News Article
System admits 10-year diagnostic waits
Patient Safety Learning posted a news article in News
Adults across an integrated care system area are facing ‘unacceptable’ 10-year waits for an NHS assessment for attention deficit hyperactivity disorder, the longest known wait for such services in England. Herefordshire and Worcestershire integrated care board has warned in board papers of “exceptionally high waiting times for ADHD assessment and treatment for Worcestershire patients (10 years+), with workforce challenges and service fragility compromising service delivery”. HSJ understands the long waits for ADHD diagnosis, which is a national problem, is predominately affecting adults with approximately 2,000 people on Herefordshire and Worcestershire’s ADHD list alone. Local provider Herefordshire and Worcestershire Health and Care Trust also warned on its website that its paediatric services were also “experiencing unprecedented demand”. Read full story (paywalled) Source: HSJ, 19 July 2023 -
News ArticleMany vulnerable patients are struggling to access covid treatments after commissioning responsibility switched to integrated care boards this week, charities have warned. Approximately two million vulnerable patients must now contact local services themselves to access treatments designed to combat covid infections, such as the antivirals Paxlovid and Sotrovimab. Integrated care boards are expected to coordinate and fund “equitable” access. Prior to 27 June, identification of patients and the delivery of treatment was coordinated nationally under pandemic arrangements. However, a group of 20 patient charities have written to Steve Barclay warning that most ICBs have not drawn up plans to deliver this new responsibility, leaving patients and primary care clinicians unclear on how to access the treatments. “Despite continually raising our concerns with those carrying out the planning, implementation, and communication of this [policy], we now find that we are in exactly the position we warned against,” they said. Read full story (paywalled) Source: HSJ, 3 July 2023
-
News Article
ICSs will be first to intervene in failing trusts, says NHS England
Patient Safety Learning posted a news article in News
NHS England has said integrated care systems (ICSs) will be responsible for ‘initial problem solving and intervention’ if trusts fail to deliver against key targets to prepare for winter. NHSE’s letter on winter planning and response, published on Friday, said system working “means a new approach to accountability” and that ICBs – the NHS executive of ICSs – would be accountable for ensuring that providers and others “deliver their agreed role in their local plans and work together effectively”. The document, signed by NHSE’s leadership, says: “ICBs are responsible for initial problem solving and intervention should providers fail, or be unable, to deliver their agreed role. “Intervention support can be provided from NHS England regional teams as required, drawing on the expertise of our national level urgent and emergency care team as needed.” Read full story (paywalled) Source: HSJ, 15 August 2022 -
News Article
What the Fuller Stocktake report means for primary care and digital technology
Patient Safety Learning posted a news article in News
The recent publication of the Fuller Stocktake report sets out a new vision for the role of primary care in integrated care systems. With primary care the bedrock of the NHS and at “the heart of communities”, the paper’s recommendation to similarly establish it at the centre of new ICS systems and foster greater collaboration is a welcome one that has been greeted positively in many quarters. However, a key priority underpinning many of the recommendations made is the need to create sustainable primary care for the future. Within this, there is a challenge to tackle “inadequate access to urgent care” which the report argues is having a direct impact on general practice’s ability to provide continuity of care to patients who need it most as well as overall primary care capacity. Referred to as being two sides of the same coin, this stark recognition of current workload and workforce challenges in general practice alongside their wider contributing factors is both timely and welcome. Read full story (paywalled) Source: HSJ, 27 July 2022 -
News Article
NHS England ‘hasn’t got long’ to develop ‘operating model’ for system working
Patient Safety Learning posted a news article in News
NHS England and local leaders must urgently develop a coherent ‘operating model’ for the era of integrated care systems (ICS) or see the reforms fail, leading trust chief executives have told HSJ. Despite ICSs formally launching on 1 July, the chiefs said there was still no clarity about how the service would be supported and held to account as the Health and Care Act reforms are rolled out and the stuttering Covid recovery continues. The CEOs were speaking at a roundtable to mark the publication of HSJ's annual ranking of the NHS’s “top 50 trust chief executives”. NHSE has been working on a new operating model since last year. It has confirmed it plans to keep its seven separate regional teams, and has recently indicated national programmes will be curbed as part of reductions to central staffing. Caroline Clarke, the chief executive of north London’s Royal Free group of trusts, said: “What’s unclear to me is, what the operating model is for [the] whole NHS? What is NHSE going to do… what’s expected of the regions and the ICSs… is the performance management line [for providers] going to go all the way through the ICS?” Ms Clarke said she recognised “some kind of regional infrastructure” was needed and that the existing set-up made sense in widely recognised areas such as London and other “urban” conurbations. But she added: “Are [regions] just going to be aggregating features of the NHS, or are they actually going to have a kind of intent to them?” Ms Clarke said she was “hung up” on getting an effective operating model because, without it, there was an increased chance NHSE staff would “get in the way and stop us making decisions”. Read full story (paywalled) Source: HSJ, 25 July 2022 -
News Article
NHS is ‘not doing a very good job’ on children’s mental health
Patient Safety Learning posted a news article in News
The NHS's approach to tackling children’s mental health is “threatening to overwhelm the social care system”, the president of the Association of Directors of Children’s Services has warned. Steve Crocker believes the NHS is “not doing a very good job” for children, describing how children are typically now waiting four months for a mental health assessment and over a year for treatment as being “simply not good enough”. He admitted he was being “deliberately provocative” around children’s mental health at the opening of the ADCS conference yesterday, as he wants to see “more collaboration” from the new Integrated Care Systems (ICSs), which were put on a statutory footing this month. Mr Crocker warned delegates that under the ICS reforms, there is an “ongoing risk that the needs of children are sidelined by the ongoing pressure in acute adult services”. “The House of Lords amendment ensuring each ICS has a children’s strategic lead was a welcome development, but does it go far enough?” he asked. Mr Crocker told LGC: “Children's mental health should be a priority for every ICS in the country. I can't imagine any reason why any ICS would not do that." Read full story Source: Local Government Chronicle, 8 July 2022 -
News Article
Delayed discharges rise in 17 ICSs despite Barclay’s £250m fund
Patient Safety Learning posted a news article in News
A high-profile £250m government intervention to free up hospital beds has so far failed to deliver any significant reduction in delayed discharges – with multiple systems instead reporting large increases. Steve Barclay announced the fund, including £200m to buy step-down residential care beds to speed up discharges, on 9 January, following a “recovery forum” crisis summit at 10 Downing Street. NHS England said in guidance on 13 January the funding must bring “immediate improvements”, and local leaders were again told to “maximise the impact of their areas’ allocation of the money in the run up to strikes on 6 February”. But according to official data, in the week the new money was announced, there was an average of 14,035 patients who did not meet the clinical “criteria to reside”, but were still waiting to leave hospital, equating to around one in seven occupied beds. The total numbers have barely changed since then, with an average of 13,975 cases reported in the week to 5 February, also representing one in seven occupied beds. Read full story (paywalled) Source: HSJ, 13 February 2023 -
News Article
Medicines blackout threatens ICS prevention target
Patient Safety Learning posted a news article in News
The government’s target for England to become smoke-free by 2030 – which integrated care systems are expected to pursue – is being undermined by the unavailability of two smoking cessation medicines. The objective, set by government in 2019, is being taken forward by many ICSs, as they seek to prevent premature illness and death, and narrow health inequalities, with smoking rates normally higher in more deprived populations. However HSJ analysis of drug shortages revealed that the two cessation medicines are both currently unavailable for an extended period. Champix (varenicline) has been unavailable since October 2021, a situation exacerbated by the absence of Zyban (bupropion), since December 2022. Both drugs were withdrawn because of concerns about the presence of nitrosamines, which may increase risk of cancer if people are exposed to them above acceptable levels, and will be subject to further tests and regulatory checks if they are to return. Matthew Evison, a lung cancer and tobacco dependency specialist at Manchester University Foundation Trust, said Champix was clinicians’ “most powerful weapon” against smoking. He said the treatment gap would make the target harder because “smoking prevalence declines will be slower without varenicline”. Read full story Source: HSJ, 30 January 2023
