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Cathy Winfield

The global pandemic has highlighted how organisations in the UK have been able to successfully work together to continue providing the best patient care.

It has also emphasised the importance of fostering easier integration across the care systems, and reignited discussions around how this can be achieved as this blog post from Stuart Bailey at Capita points out.

Greater integration within health and social care is a key ambition of the NHS Long Term Plan, with the aspiration that all areas of England will be covered by an Integrated Care System (ICS) by April 2021.

Regulation around ICSs is yet to be finalised. NHS Improvement (NHSI) and NHS England (NHSE) recently published a consultation document proposing legislative changes to give ICSs ‘a firmer footing’ and  facilitate greater collaboration. The report outlines the opportunities for ICSs to ‘reduce bureaucracy through increased collaboration, leaner oversight through streamlined assurance structures and smarter data-sharing agreements’.

In the paper, NHSE puts forward two options for legislative reform: a statutory committee model with an Accountable Officer that binds together current statutory organisations, and a statutory corporate NHS body model that additionally brings CCG statutory functions into the ICS. NHSE believes both these options would be ‘sufficiently permissive’ to allow systems to shape how they operate and deliver care. The consultation on these proposals concludes this month.

Regulatory bodies are more used to overseeing single organisations than a collaborative, but in order for ICSs to move forward and perform to the highest of standards, a common assurance framework will be crucial. This framework needs to be developed so it binds organisations together rather than pulling them apart.

ICS member organisations in each area will face their own challenges but financial and workforce constraints will be common to every ICS, so building flexibility into the regulatory framework - that allows ICSs to address these collectively - is key.

ICSs must also be able to benchmark themselves against peers with similar challenges to identify areas of improvement. To do this, they must measure against a defined, consistent set of metrics. Digital maturity and data quality, however, vary considerably across systems, and data can still be held in siloes.

The recently launched NHS Viewpoint dashboard is a valuable tool that allows organisations to drill down to a local level and identify variation in practice which will enable them to address issues such as health inequalities. ICSs will want to capitalise on the insights this will deliver, ensuring they are widely consumed and actionable, becoming data driven, evidence-based organisations.

It will be interesting to see what legislative developments take place, but the fact that the need for change has been recognised and that public bodies are working to accelerate greater integration is very promising.

Read our latest report on the need for better data sharing to improve the integration of health and care integration.

Written by


Cathy Winfield

Advisor to NHS England and member of our Advisory Board

Cathy Winfield, is Advisor to NHS England and is a member of our Advisory Board. The Advisory Board was formed to ensure CHKS (the healthcare intelligence and improvement experts of Capita) continues to meet the needs of health and social care organisations. Board members are senior leaders working in health and social care.

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