How are Integrated Care Systems organising health and care?

We sat down with Dr Penny Dash, Chair of North West London ICS, to discuss the stages of maturity, successes they’ve had and how ICSs may evolve in the future.

Integrated Care Systems (ICS) became legal entities in July 2022 and the way Integrated Care Partnerships (ICPs) have been established and how Integrated Care Boards (ICBs) are organised, is still emerging. With localised priorities, the individual ICS’ agendas can vary – meaning their approach to the challenges faced may differ.  

The challenges facing an ICS 

An ICS is a partnership of organisations involved in the health and care of a defined population including local authorities, NHS Trusts (acute, community and mental health), GP practices and voluntary sector services. Within this, Integrated Care Boards are statutory NHS organisations responsible for developing a plan for meeting the local health needs – managing the NHS budget and arranging services.

The ICBs are facing a common set of challenges. As Penny states, one of the most significant is the health status of the population ‘…it is not improving and actually possibly getting worse.’ She highlights that the dramatic increase in life expectancy and the number of years lived healthily, due to improvements in cardiovascular health and cancer, is levelling out and even, going into decline. With several organisations involved, addressing overall health status and inequalities can be quite complex.  

Penny also addresses the challenge posed in co-ordinating and integrating local services – the quality and ease of access to primary care, community care, mental healthcare and social care is not where it needs to be and should be tackled. 

Finally, hospital services could be organised and run more efficiently, helping to tackle the waiting list, if care models are addressed and resources organised more effectively. Watch the full interview now:

What successes are being realised?      

Bringing the NHS and local authorities together to discuss improvements in people’s health and address inequalities is one good thing to emerge from the creation of ICSs. By having coordinated data, prioritisation and allocation of resources can be discussed – as Penny explains, an ICS can then assess ‘where is there the greatest need? Where can we have the biggest impact?’ At a local level, the sharing of best practice for that population can also occur, roles and responsibilities can be clarified, and service investment can be agreed.    

Where acute hospitals were once in competition with each other, a move to systems has supported them to work more effectively together. 

Having a localised approach enables you to plan for new models more effectively – such as the implementation of digital tools, assessing and interpreting data and their systems and supporting research, innovation and its local adoption.   

How supply partners can help ICSs achieve their objectives 

Penny suggests that all the organisations involved in delivering health and care for a geography should be on the same page and striving to achieve the same objectives.  She recommends that suppliers, alongside the healthcare delivery organisations within an ICS, are focused on working towards their four key objectives, which are:  

• Improve outcomes in population health and healthcare  
• Tackle inequalities in outcomes, experience and access  
• Enhance productivity and value for money   
• Help the NHS support broader social and economic development.   

By asking three simple questions, suppliers can determine whether they’re focused on the initiatives most likely to resonate with an ICS:  

1. How are you contributing towards improving health?  
2. Are you supporting the delivery of high-quality care?  
3. Are you helping to improve the delivery of efficient, productive services?  

Ultimately, as Penny explains, ‘efficiency and productivity are the biggest levers the ICSs have, to help more people, to improve health of the population and to reduce inequalities in health.’   

Suppliers, as well as delivering services, also have a role in the final objective - by supporting the health and wellbeing of their employees and by considering how local employment improves people’s health more widely.   

Discover more about how ICSs are evolving, where they might develop in the future and how, by all working in partnership, they are better able to achieve their objectives.