On 11th February 2021, the Department of Health and Social Care published the White Paper Integration and innovation: working together to improve health and social care for all, which sets out legislative proposals for a health and care Bill.
Intro commentary by Helen McKenna of The King’s Fund
At the heart of the changes set out in this section is the proposal to establish integrated care systems (ICSs) as statutory bodies in all parts of England. ICSs will be made up of two parts – an ‘ICS NHS body’ and an ‘ICS health and care partnership’. The dual structure is a new development and recognises the two forms of integration that are needed to adopt a population health approach aimed at improving the health and wellbeing of local populations: integration within the NHS (between different NHS organisations) and integration between the NHS and local Government (and wider partners).
The ICS health and care partnership will be responsible for developing a plan to address the system’s health, public health and social care needs, which the ICS NHS body and local authorities will be required to ‘have regard to’ when making decisions. The membership of the partnership and its functions will not be set out in legislation – instead, local areas will be given the flexibility to appoint members (likely to be from the wider system – for example, Healthwatch, voluntary and independent sector providers, and social care providers).
The document also recognises the importance of ‘place’, which is a smaller footprint than that of an ICS, often that of a local authority. Experience suggests that much of the heavy lifting of integration and improving population health is driven by organisations collaborating at this level and successful ICSs have therefore often concentrated their efforts on developing the places within their footprint. The Department states that it has decided against giving place a statutory underpinning although it is explicit that there will be an expectation that ICS NHS bodies delegate ‘significantly’ to place level as well as to provider collaboratives. The development of place-based partnerships will therefore be left to local determination, building on existing arrangements where these work well. ICSs will be expected to work closely with health and wellbeing boards and required to ‘have regard to’ the joint strategic needs assessments and joint health and wellbeing strategies produced by health and wellbeing boards.
To read Helen’s commentary in full, visit The Kings Fund website.
What else was promised?
The Government said a new power for the Secretary of State to make payments directly to adult social care providers will remove a bureaucratic barrier to delivering support to the sector in exceptional circumstances. The DHSC also said it wants to increase accountability in the delivery of social care through an enhanced assurance framework examining the performance of local authorities and a new power to collect data from providers.
The White Paper outlines that the Government aims to build on improvements made by existing tools such as the capacity tracker mandated during the pandemic and an increased ability to gather data from social care providers (for both local authority and privately funded care) and that they will remedy gaps in available data to help the Government understand capacity and risk in the system.