Journey to becoming an ICS

The journey to becoming an integrated care system (ICS)

In 2016, NHS organisations and local councils came together to form sustainability and transformation partnerships (STPs) that cover the whole of England, setting out their individual proposals to improve health and care for patients. Cheshire and Merseyside Health and Care Partnership is the second largest of the 44 STPs established by NHS England.

For the most advanced STPs, integrated care systems (ICSs) are the next step; representing a more advanced level of integration and system-wide working. From the 44 STP footprints, 18 ICSs have already emerged, meaning around half of the country’s population is now covered by an ICS.

In an ICS, NHS bodies (commissioners and providers), local authorities and third-sector providers each take collective responsibility for the management of resources, delivering NHS standards and improving the health of the population they serve.

When different organisations work together in this way, local services can provide better and more joined-up care for patients. ‘Systems’ can better understand data about local people’s health, allowing them to provide care that is tailored to individual needs. For staff, the improved collaboration can help to make it easier to work with colleagues from other organisations.

The benefits of becoming an ICS are:

The potential to achieve better outcomes and a less fragmented experience for patients and service users, ensuring they have a single journey that’s agreed by the teams involved in their care. This should significantly reduce the delay and debate that occurs in the current system – something which can cause individuals to ‘fall through the cracks’, exacerbating demand and poor outcomes.
The opportunity to create a reduction in wasted effort, improve transfer of information from one professional to another, fewer overall transactions and more joined-up leadership – something which recognises and can help put in place, the right care arrangements at a local and regional level for their populations.
Improved financial efficiency gained from a system that pools knowledge, expertise and financial resources. An ICS is better equipped to meet future, and in some cases (as we’ve seen during the coronavirus pandemic), unexpected demand on services in what are already financially challenging times. The savings gained can then be used for new services and initiatives that support preventative measures and public health.

The NHS Long-Term Plan

The NHS Long-Term Plan sets out the ambition that every part of the country should be an integrated care system by April 2021. In order to mature into an ICS, sustainability and transformation partnerships (STPs) must achieve objectives in three core areas. These include:

Building wider partnerships with local government and other community partners, to better understand data and other intelligence about the health and well-being of all people in their area. This allows for improvements in day-to-day physical and mental health, as well as reductions in health inequalities between different groups.
Creating capacity for implementing the system-wide changes that will improve health results and quality of care, by taking on shared responsibility for how they use their collective resources, including agreed cross-system spending totals.
Improving quality and access to care by managing NHS resources more efficiently and effectively – in order to improve health outcomes and reduce inequalities (in quality, access and outcomes).

Is the Cheshire and Merseyside Health and Care Partnership an integrated care system?

The Cheshire and Merseyside Health and Care Partnership is well on its way to becoming an ICS, focusing on strengthening collaborative relationships across the system by bringing the NHS, councils and communities together to improve health and care for our population.

This is further supported through integrated care partnerships (ICPs) which are alliances of NHS providers that, instead of competing, agree to collaborate and work together to deliver care. These providers include hospitals, community services, mental health services and GPs and, in some cases, social care, independent and third-sector providers.

The Cheshire and Merseyside Partnership Board is strengthening the system architecture and the effectiveness of partnership governance. Our executive team is working with the nine areas in the Cheshire and Merseyside footprint to bring together the organisations, in order to achieve the Partnership’s mission; to tackle inequalities and improve the lives of our poorest, fastest.

As chairman, Alan Yates highlighted in our first Partnership Assembly meeting, “We believe we can achieve this mission best by working in partnership; with an emphasis, not just on health, but on inequalities – because the Partnership isn’t NHS-led, but a broad coalition of local authorities, voluntary organisations and other vital organisations who enjoy parity.”

To support this, a collaborative commissioning forum is already in place. This brings together the Clinical Commissioning Groups across Cheshire and Merseyside, with the aim to progress the integration of health and social care – and collaboratively commission consistent and efficient services for patients across the system.

We have also established a number of other networks across the system, with the aim to support collaborative working across organisations, enabling leaders to share learning and best practice. To promote collaboration, there is an organisational development programme in place across the system, offering system leadership programme and support.