Search the hub
Showing results for tags 'Integrated Care System (ICS)'.
Found 189 results
-
Content ArticleIntegrated care systems (ICSs) were created to increase collaboration in the health and social care sector and to enable the NHS, local authorities and other partners to take collective responsibility for improving health outcomes, reducing inequalities, delivering better value for money, and driving local social and economic development. This research from the King's Fund examines the development of ICSs by assessing their efforts to develop system-wide approaches to the recruitment, training and retention of staff. The findings are based on 24 in-depth interviews with local leaders in four case study sites plus a series of online workshops.
-
EventThe landscape of commissioning, its arrangements and responsibilities are regularly shifting and can be complex. The terminology used may change but whether it is called commissioning, strategic commissioning or population health management it is important to recognise that effective health services need to be properly planned, designed and resourced – so the work of commissioning is, and will remain, vital. Join this two-day virtual event from the King's fund to be at the forefront of discussions about how the narrative around commissioning and its future is changing, and how organisations from different parts of the sector can get involved in designing and improving the services, both for those working in the health and care system and for the people and communities who use health services. Sessions will bring together individuals and teams across the health and care system to showcase different examples of how commissioning is being used to plan and transform services. These will aim to inspire you to think differently about commissioning and the way organisations can work together to achieve effective commissioning process across the health and care system. It will also explore how regions, integrated care boards and place-based partnerships will need to work together to design, improve and deliver services. You will also learn how the culture around commissioning, planning and improvement is changing as the system moves towards a more collaborative approach. Register
-
Content ArticleThis toolkit is designed to support integrated care systems (ICSs) to design, plan, and deliver high-quality treatment and care for children and young adults aged 0-25 years with all types of diabetes.
-
News Article
Threefold ICS variation in GP phone access revealed
Patient Safety Learning posted a news article in News
Patients trying to reach their GP are almost three times as likely to fail to get through in the worst-performing integrated care systems (ICS) than the best, according to analysis of new annual figures. The data is from NHS England’s annual GP patient survey, which has a large sample size, and is considered one of the best measures of GP access and experience. In Birmingham and Solihull and Black Country, 7% of patients said their calls went unanswered — significantly lower than the best-performing systems at 2%, and the national average of 4%. Some more urban and racially diverse areas tended to do worse on key GP access measures – such as Birmingham, the Black Country, large parts of London, Greater Manchester, and Bedfordshire, Luton and Milton Keynes – although more rural patches like Northamptonshire and parts of the South West also have big problems. NHSE said in a statement: “NHS staff have worked incredibly hard to cope with increased demand for patient care, but this survey makes it clear there is much more to do to improve patient’s satisfaction and experience in accessing primary care services.” It will work with the government to “tackle the issues that matter most to patients” including long-term conditions, continuity of care and patient access, it added. Read full story (paywalled) Source: HSJ, 12 July 2024 -
Content ArticleAlzheimer’s Society estimates that there are currently around 900,000 people living with dementia in the UK. Unlike other major conditions, there is no national clinical pathway for dementia, and despite there being a national target, there is wide variation in dementia diagnosis rates across England. Alzheimer’s Society commissioned The King’s Fund to explore the development of Integrated Care Systems (ICSs) through the lens of dementia diagnosis—to consider what opportunities ICSs present to approach dementia differently and to improve diagnosis rates by doing so. The research team explored enablers and barriers to improving dementia diagnosis through interviews with stakeholders and people affected by dementia in three case study ICSs.
-
Content ArticleThe latest report in Public Policy Project’s Medicines and Pharmacy programme calls for transformation across the pharmacy sector to unlock medicines optimisation which creates true system value. The report highlights that medicines optimisation has significant potential to contribute to delivering integrated care priorities, such as improving population health and reducing inequalities. As ICSs grapple with financial challenges, medicines, as the second highest cost to the NHS, represent a critical opportunity to improve patient outcomes and deliver better value for money.
-
News Article
New crackdown on ICSs that ‘discourage’ referrals to private hospitals
Patient-Safety-Learning posted a news article in News
NHS England will begin monitoring and benchmarking systems on the extent to which patients are given the option to be treated by a private provider. The move follows the government today endorsing the recommendations of a review by the chair of the newly created Independent Patient Choice and Procurement Panel, which has highlighted how some local areas are restricting patient choice. It highlighted significant variation in choice between some systems, which it said was driven by factors including messaging from commissioners to GPs that discourages choice and/or encourages referrals to local NHS trusts, financial incentives for referrals to particular providers and difficulties in securing accreditation from commissioners. It cited one example where the operator of an independent sector hospital that is co-located with an NHS hospital was contractually prevented by the NHS trust from accepting certain referrals. Health and social care secretary Victoria Atkins said: “Empowering patients to take control of their own healthcare decisions is a key part of my missions to make the NHS faster, simpler and fairer for everyone that uses it.” Read full story (paywalled) Source: HSJ, 15 May 2024 -
News Article
£500m cut to local integration funds revealed
Patient-Safety-Learning posted a news article in News
Integrated care boards and local authorities are cutting their voluntary contributions to the better care fund by more than £500m compared to a high point in 2021-22. It appears to be caused by the funding squeeze in both the NHS and local government; extra pressure on ICBs to focus on hospital admissions and discharge; a shift away from pooled budgets as a method of integration; and restructure, with ICBs taking over from clinical commissioning groups in 2022. Local BCF pooled budgets are made up of mandatory “minimum” funds from ICBs and local government – the largest share, which the government has generally ordered to grow steadily each year – and from the “additional” voluntary contributions. In the past government has said it wants the sum pooled across the NHS and councils to grow and to ultimately account for most NHS and adult social care spending, to help join up services and decision making. But figures published on Tuesday by NHS England show the voluntary income going backwards. At its high point in 2021-22, ICBs and councils planned a discretionary ”additional” contribution of £3bn, and the actual spend turned out to be £3.2bn – £2bn from the NHS and £1.2bn from councils. The newly published figures show the total was planned to fall to £2.8bn in 2023-24 and £2.7bn in 2024-25 – £500m less than the 2021-22 peak spend. Read full story (paywalled) Source: HSJ, 8 May 2024 -
News Article
ICS stops referrals to largest private provider
Patient-Safety-Learning posted a news article in News
A health system has stopped sending mental health patients to the country’s largest single provider of out-of-area placements. Southern Hill Hospital in Norfolk provided more than 18,000 bed days classed as OAPs for NHS patients last year, with Greater Manchester Integrated Care System (GM) being the main contributor to that total. However, HSJ has learned that GM’s integrated care board and mental health providers have decided not to send any more patients to the provider. The move comes after a recent visit to and review of the service at Southern Hill by GM commissioners. This, in turn, followed concerns about the “co-ordination” of patient care at Southern Hill received by GM. The exact nature of the concerns is unclear, and the ICB said in a statement “no significant safety or quality concerns were found and feedback from patients was positive,” when it carried out its review. The ICB said the decision to cease placements at Southern Hill shortly after the concerns were raised was a coincidence, and that the move was part of its strategy to reduce OAPs. Read full story (paywalled) Source: HSJ, 2 May 2024 -
Content ArticleThe health needs of the population are changing as it ages. Health services, particularly in secondary care, have traditionally been designed to deal with patients with a single disease, but for a growing number this is no longer a suitable model of care. Primary care has been at the vanguard of delivering more person centred and whole-person care, but many of the existing policy measures and incentives within it are outdated and aimed at managing single diseases. This report by Future Health sets out a series of recommendations for developing the Major Conditions Strategy to encompass a wider range of long-term and multiple conditions, putting patients rather than specific conditions at the centre. It also provides new data on the rising challenge of long-term conditions and in particular multiple long-term conditions.
-
Content ArticleThis toolkit is a practical guide for system leaders that will help to inform future spending on health inequalities and support implementation of high-impact changes within integrated care boards (ICBs) to address health inequalities. It aims to build system leaders’ confidence in their ability to tackle inequalities in their organisations and is accompanied by a research report that looks at the approaches systems took to spending health inequalities money. It is structured in line with the four main stages of quality improvement methods: Culture, leadership and governance Understanding the problem Developing the best solution Evaluating success
-
News ArticleLeaders of an integrated care system in the Midlands have warned they cannot make the scale of staffing cuts required to balance the books without putting patients at risk. Indicative analysis produced by Staffordshire and Stoke-on-Trent Integrated Care Board also found its provider trusts would have to cut 10 per cent of their workforce to break even. This would equate to 2,300 posts across University Hospitals North Midlands, Midlands Partnership Foundation Trust and North Staffordshire Combined Healthcare, while the ICB would have to cancel a “very high proportion” of third-sector contracts. The document says this “would bring our teams below safe staffing levels” and have a “profound effect on our ability to deliver safe services”. Read full story (paywalled) Source: HSJ, 23 April 2024
-
Content ArticleIntegrated Care Boards (ICBs) are responsible for commissioning and funding care provided by the various healthcare providers in its area, such as hospital trusts and community trusts. This blog offers patients practical advice on how to hold their ICB to account, for example, by raising questions at their ICB's monthly or bimonthly meeting.
-
News Article
One in seven callers could not reach GP in worst-performing ICS
Patient Safety Learning posted a news article in News
People attempting to contact their GP practice are almost three times as likely to report failing to get through in some integrated care systems (ICS) than others, according to NHS England-commissioned data. The survey figures, collected for the first time by the Office for National Statistics (ONS), show 8.5% of people nationally who tried to call their GP between mid-January and mid-February this year said they could not reach the practice. This equates to 1.5 million people across England, according to the ONS. In Northamptonshire – the worst performing ICS – 14.7% of callers did not manage to make contact. That is the equivalent of around one in seven people. By comparison, only 3.9% of callers in Gloucestershire, the best performing ICS, could not get through. The findings are broadly similar when population and age are accounted for. Read full story (paywalled) Source: HSJ, 12 April 2024 -
News Article
The ICSs ‘diverting’ the most GP referrals through controversial model
Patient Safety Learning posted a news article in News
There is huge regional variation in the rate at which health systems are preventing patients joining the elective waiting list through “advice and guidance” to GPs, according to analysis by HSJ. Some systems – including Northamptonshire – have managed to ramp up these “diverts” to such an extent that they now report around one A&G case to every 3.5 cases cleared from the waiting list through treatment or seeing a consultant. This contrasts with others, such as Lancashire and South Cumbria, which only reports one A&G case for every 16 cleared from the waiting list. Advice and guidance involves GPs consulting specialists before making direct referrals and around half the time this results in a referral being avoided. The model is set to be a cornerstone of NHS England’s new outpatient transformation strategy, which is due imminently. Victoria Tzortziou-Brown, vice chair of the Royal College of GPs, said the analysis “confirms reports we’ve heard from our members – that there is too much regional variation in the use of the ‘advice and guidance’”. She added: “Some GPs report that when advice and guidance is properly resourced and well implemented, it can be a helpful tool for improving communications with their colleagues in secondary care. “[But] it is clear that more time, funding and capacity needs to be dedicated to allow clinicians to communicate efficiently and effectively whilst respecting professionalism.” Read full story (paywalled) Source: HSJ, 9 April 2024 Related reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs -
News Article
New CQC inspections put on hold by ministers
Patient Safety Learning posted a news article in News
The Care Quality Commission’s assessments of integrated care systems (ICSs) have been put on hold at the last minute, as the government declined to sign off on the process. They were due to begin this month, following pilots in Birmingham and Solihull and Dorset ICSs, but the Care Quality Commission (CQC) has put the brakes on assessments elsewhere until it receives government approval. Under the legislation brought in when ICSs were set up in 2022, the CQC can review and assess systems, but ministers must approve its methodology. Interim chief inspector of adult social care and integrated care James Bullion wrote to integrated care board chiefs this week stating that, following discussions with the Department of Health and Social Care, the CQC had agreed to a “short delay… to allow for further refinements to our approach”. He added: “In particular we have been working with NHS England on their strengthened approach to performance evaluation and rating of the ICB elements of the ICS which we will take into account as evidence for our scoring and reporting approach.” Read full story (paywalled) Source: HSJ, 8 April 2024 -
Content ArticleThe NHS England 2024/25 priorities and operational planning guidance reconfirms the ongoing need to recover core services and improve productivity, making progress in delivering the key NHS Long Term Plan ambitions and continuing to transform the NHS for the future.
-
Content ArticleThe Children and Young People’s Health Equity Collaborative (CHEC) is a partnership between the UCL Institute of Health Equity (IHE), Barnardo’s and three Integrated Care Systems (ICSs), Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire. The CHEC sees action on the social determinants of health as essential in improving health outcomes among children and young people and reducing inequalities in health. The CHEC recognises that social determinants of health are generally not sufficiently addressed in policies, services and interventions that aim to support better health among children and young people. This framework has been developed by the CHEC with direct input from children and young people local to the three ICSs. The CHEC Board were also involved in its development. The framework’s main purpose is to underpin action for achieving greater equity in children and young people’s health and wellbeing and will be used to support the development of pilot interventions in the three partner ICS areas. There is an ambition for the framework also to be used more widely, encouraging other ICSs to take action on the social determinants of health among children and young people.
-
News Article
ICB shelves same-day hub plans due to GP and patient backlash
Patient Safety Learning posted a news article in News
Same-day access hubs will not be mandated in North West London as the Integrated Care Board (ICB) bows to pressure from GPs and patients. In a letter to GP teams, seen by Pulse, the ICB said that their controversial same-day access programme "will not form part of the single offer for enhanced services for 2024/25". Instead, ICB leaders said they want to work with PCNs "to consider how access can be improved" and that they do not have a "presumption" about a "particular model" all PCNs should adopt. They are now aiming for a new model to be implemented from April next year instead. The hub model aimed to "deliver a single point of triage for same-day, low complexity" demand for all 2.1 million residents within the integrated care system, leaving GP practices with only longer-term, "complex" care. But London GP leaders, as well as patients, raised "immense concern" with the plans, including patient safety, quality of care, and logistics. In response to these concerns, the ICB confirmed yesterday that it has "adjusted" the same-day hub programme, and that it wants to "move forward collectively" to address both patient access issues and GP pressures. Read full story Source: Pulse, 6 March 2024 -
News Article
CEO admits ‘risk aversion’ clogging up hospitals
Patient Safety Learning posted a news article in News
Medics and managers must overcome a system-wide “aversion” to risk after their integrated care system was identified as a national outlier for low numbers of patients discharged home, according to the ICS’s chief executive. Kate Shields, CEO of Cornwall and Isles of Scilly ICS, has highlighted a discrepancy between the ICS and the rest of England, with a lower proportion of patients discharged with no new social care requirements, or discharged directly to their own home, with only intermediate additional care (known as ”pathways” 0 and 1 in national discharge guidance). Problems with delayed patient discharges – known as “no criteria to reside” patients – are a major contributor to overcrowding and long waits in the emergency department at Royal Cornwall Hospitals Trust, as well as severe delays for ambulances to handover patients. Discharge on pathways 2 and 3 – to a care home or intermediate care bed, with substantial additional care requirements – typically take a lot longer, and require more resources. Ms Shields’ comments come 18 months after an external report warned of an “over-reliance on bedded care” in Cornwall. Speaking at a meeting of Cornwall and Isles of Scilly Integrated Care Board last month, Ms Shields said the health economy needed to “look at how we get people out of hospital faster”. Read full story (paywalled) Source: HSJ, 4 March 2024 -
Content ArticleThis report by The King's Fund argues that the health and care system in England must shift its focus away from hospital care to primary and community services if it is to be effective and sustainable. It looks at a wholesale shift in the focus towards primary and community health and care across leadership, culture and implementation. Successive governments have repeated a vision of health and care services focused on communities rather than hospitals, but that vision is very far from being achieved. The report outlines research that explored the underlying factors that have prevented change, and what might need to be done to achieve the vision. The researchers analysed published evidence and national datasets, and interviewed stakeholders across the health and care system. The report concludes that to achieve community-based care, political and other national leaders will need to completely shift their focus away from hospitals towards primary and community health and care.
-
Event
King's Fund: Health and care explained
Sam posted an event in Community Calendar
untilThe landscape of the health and care system in England is challenging and complex, and the system is facing profound challenges. At this event, which will take place virtually over two days, policy and leadership experts from The King’s Fund will help you gain a greater understanding of how the health and care system in England works and how it is changing, giving balanced and honest views about the pressures and opportunities it faces. In the run-up to the anticipated general election, our experts will also explore which health and care topics are likely to dominate at the election and which are not, and what this means for people working in the sector. Delegates will: make sense of how the NHS is structured and funded learn how various components at system, place and neighbourhood levels come together to create integrated care systems (ICSs) gain an understanding of the key components of primary care and the role they play in the health care system hear about health inequalities and how groups from the voluntary, community and social enterprise (VCSE) sector support wider efforts to improve health inequalities gain a clear understanding of how the social care system is structured, who works in it, and how it is funded learn about the current pressures facing the health care workforce and what this means for the sustainability of the system have the opportunity, through a dedicated session, to ask any questions not answered throughout the event. Register -
Content ArticleThis blog by Healthwatch outlines research conducted by the organisation that shows the issues homeless people face accessing the health and social care they need. The research demonstrates that homeless people: have particular problems accessing GPs and other services. experience serious problems accessing NHS dentistry. may forgo care because of the costs of travelling to appointments. often feel judged by healthcare professionals and not well cared for. The blog also discusses the impact that integrated care systems could have in improving accessibility and quality of care for homeless people.
-
News ArticleThe medical leaders of the maternity unit of a flagship hospital threatened with closure have written to their chief executive saying the downgrade would not be safe, HSJ has learned. Nineteen obstetric and gynaecological staff, including the clinical director, wrote to the chair and CEO of the Royal Free London Foundation Trust this week saying the proposals to shutter services at the trust’s main site in Hampstead would increase the risk of harm to mothers. Their letter said: “Whilst we accept, and support, the need to review provision of maternity and neonatal services across [north central London], aiming for care excellence and best outcomes, we have significant concerns about the current proposals.” The letter said the Royal Free was the only unit in NCL to offer a “range of supporting specialist services for complex maternity care”, including rheumatology and neurology and is the “only hospital in NCL to provide both 24-hour interventional radiology and on-site acute vascular surgery and urology support”. The medics’ letter said co-morbidities from cardiac, renal, haematological and neurological conditions had driven an increase in maternal mortality over the past decade and that RFH’s services were well-equipped to manage these complex cases. Read full story (paywalled) Source: HSJ, 24 January 2024
-
Content ArticleThis statement from NHS England outlines how NHS organisations should collect and present data on health inequalities and explains the powers available to them to collect such data. Integrated care boards, trusts and foundation trusts should use the statement to identify key information on health inequalities and set out how they have responded to it in annual reports. The statement has been produced according to NHS England's duty under section 13SA of the National Health Service Act 2006.
