NAPC responds to NHSEI Integrating care:  Next steps to building strong and effective integrated care systems across England

NAPC responds to NHSEI Integrating care: Next steps to building strong and effective integrated care systems across England

NAPC is the organisation that created the notion of place

On Monday 30 November, NHS England and NHS Improvement held a board meeting to discuss an engagement paper that outlined proposals for legislations around integrated care across England. See the paper here. The paper builds on the route map in the NHS Long Term Plan, for health and care to be joined up locally around people’s needs.

With the aim of greater collaboration across health and care systems, the report outlines two options for integrated care system (ICS) legislation which would be subject to parliamentary review.

  1. Statutory ICS Board / Joint Committee with Accountable Officer (AO) – mandatory ICS board through joint committee to enable NHS commissioners, providers, and local authorities to take decision
  2. Statutory ICS body – taking on commissioning functions of CCG’s, CCG governing body and GP membership model replaced by board representative system partners.

NAPC and Place Based Care

With over 20 years’ experience in building and supporting collaboration across the health and care system, NAPC and its members welcome the NHSE/I paper proposals. NHSE/I transformation policy has long endorsed the NAPC’s approach to primary care network development and working across place and systems with a population health focus.

NAPC, as the architects of the primary care home model (PCH), the original primary care network (PCN) based around 4 characteristics: an integrated workforce, a strong emphasis on partnerships spanning primary secondary and social care, the personalisation of care and population health outcomes and aligning clinical and financial drivers within a defined population.

These principles and approach apply across the system integration proposals and our continued organisational strategy in supporting health and care teams to transform how they serve populations. We have experience supporting over 350 PCNs, 5 ICSs and 4 sustainability and transformation partnerships (STPs) to deliver integrated care.

NAPC: Our View 

NAPC recognise the acceleration towards fully Integrated Care Systems through legislative changes in development brings about opportunities and challenges.

Opportunities will deliver more focus on local communities, holistic needs approach, aligning resources and teams. These opportunities need to be seized upon to accelerate the drive to a health not illness service – turning aspiration into reality.

Challenges for primary healthcare are that, if the proposals are not led effectively, they could invoke a top down approach, ever more distance from decision making to front line staff and possibly lead to disempowerment. Being seen as a system partner influencing the commissioning and care for our populations will remain vital for first contact care. Critical to that success will be new ways of working with all providers, local government, and social care.

We are currently seeking the views of our wide-ranging membership colleagues through a national survey on the paper proposals in order to voice collective recommendations from system partners for the consultation process.  Early indications from members suggest “it would allow a degree of responsibility and ownership across systems to truly integrate.”

Survey results

Thank you to those who have responded to the NAPC survey on the NHSEI engagement paper.

NAPC recognise the acceleration towards fully Integrated Care Systems (ICSs) through legislative changes in development brings about opportunities and challenges. Opportunities will deliver more focus on local communities, a holistic needs approach and aligning resources and teams. These opportunities need to be seized upon to accelerate the drive to a health not illness service – turning aspiration into reality.

Challenges for primary healthcare are that, if the proposals are not led effectively, they could invoke a top down approach, ever more distance from decision making to front line staff and possibly lead to disempowerment. Being seen as a system partner influencing the commissioning and care for our populations will remain vital for first contact care. Critical to that success will be new ways of working with all providers, local government, and social care.

Our collective responses is as follows:

Q1: Do you agree that giving ICSs a statutory footing from 2022, alongside other legislative proposals, provides the right foundation for the NHS over the next decade?

Over 45% agreed with the direction of travel with 14% strongly agreeing that giving ICSs a statutory footing from 2022, alongside other legislative proposals, provides the right foundation for the NHS over the next decade.

Q2: Do you agree that option 2 offers a model that provides greater incentive for collaboration alongside clarity of accountability across systems, to Parliament and most importantly, to patients?

Over 38% agreed that option 2 offers a model that provides a greater incentive for collaboration with 9% strongly agreeing that the model will provide clarity of accountability across systems.

Q3: Do you agree that, other than mandatory participation of NHS bodies and Local Authorities, membership should be sufficiently permissive to allow systems to shape their own governance arrangements to best suit their populations needs? 

Over 36% agreed with 31% strongly agreeing that membership should allow systems to shape their own governance arrangements to suit their populations needs.

Q4: Do you agree, subject to appropriate safeguards and where appropriate, that services currently commissioned by NHSE should be either transferred or delegated to ICS bodies?

Over 45% agreed with 18% strongly agreeing that services currently commissioned by NHSE should be transferred or delegated to ICS bodies where appropriate.

Thank you to those who took the time out to complete the survey – your feedback and insight is essential in helping us inform healthcare policy and legislations collectively.

We really appreciate your feedback and if you have any questions in regard to the survey, please contact us at napc@napc.co.uk.

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