Integrated care system in London: challenges and opportunities ahead
- Collection:
- Health Policy and Services Research
- Author(s):
- Charles, Anna, author Naylor, Chris, author Murray, Richard, author
- Contributor(s):
- King's Fund (London, England), issuing body.
- Publication:
- [London, England] : The King's Fund, February 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care, Integrated -- organization & administration Health Workforce -- organization & administration National Health Programs -- organization & administration COVID-19 Social Support London United Kingdom
- Genre(s):
- Technical Report
- Abstract:
- Key messages. The development of integrated care systems (ICSs) across England is the latest step in a series of policy measures intended to encourage closer partnership-working between local NHS organisations, local authorities, voluntary sector organisations and others. Over time, these partnerships will have greater collective responsibility for managing NHS resources and performance and for changing the way care is delivered. (1) The five systems that now cover London have their roots in partnerships established in 2016. Over the five years since then, relationships and trust between local leaders have strengthened, and the ways of working and governance arrangements that underpin the partnerships have matured significantly. (2) Lessons appear to have been learnt from the shortcomings in the process of developing the original system plans in 2016. When new plans were developed in 2019, there was much greater emphasis on clinical involvement and patient and public involvement. Importantly, local government leaders now report being more involved in the work of ICSs and shaping their priorities, a significant shift since the early days of the partnerships. (3) Responding to the Covid-19 pandemic required organisations to work together more closely than ever before. Leaders report that having a shared sense of purpose, more frequent contact, and the temporary suspension of some national requirements all helped to create the conditions for rapid progress. More work will be needed to sustain this progress beyond the pandemic and ensure it is not undone by the re-emergence of long-standing barriers to integration. (4) Some changes to NHS services were introduced rapidly during the pandemic to help the system cope with the additional pressures created by Covid-19. Where these may become permanent, they will need to be subject to appropriate democratic scrutiny and consultation. (5) The pandemic response led to rapid adoption of digital technologies in health and care. In building on the progress made, there are issues that will need to be addressed such as information governance and digital exclusion. System partners are now more focused on tackling the major health inequalities that exist in London, creating a moment of opportunity for lasting change. The priority should now be to move from ambition to delivery, with action needed at a borough, ICS and London level. The Mayor has a crucial role to play through his leadership of the London Health Inequalities Strategy. (6) Workforce constraints remain the biggest risk for health and care in London. With many workforce responsibilities being passed to ICSs, bold and co-ordinated action is needed to ensure that initiatives to address these constraints add up to a comprehensive plan that ensures health and social care services across the city have access to the workforce they need for the future. (7) The state of London's health and care estate also remains a key strategic issue and will need to be a major focus for collaborative working going forward. (8) ICS leaders should strengthen efforts to involve local authorities in ICSs and develop integrated approaches to health and social care. Fundamental weaknesses in the social care market require a regional and national response, while the pandemic has underlined that investment in and reform of social care are more urgent than ever. (9) Public finances are under enormous pressure as a result of the pandemic, with local government finances under particular strain following a decade of budget cuts. There is a significant risk that these pressures will make it harder for organisations to continue working together to make the best use of NHS and local government resources. (10) It will be critical that London's ICSs build on the progress made to ensure that collaborative working becomes a reality for all parts of the system, including clinicians, social care providers and communities. Ongoing evolution of structures and governance arrangements will be needed to underpin this in the longer term and to reflect developments in national policy, particularly the emerging roles of provider collaboratives and local place-based partnerships, and the prospect of ICSs being placed on a statutory footing.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (64 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918299681206676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918299681206676