Integrated Care Systems were established to bring together providers and commissioners of NHS services, local authorities and other local partners to plan and improve health and care services to meet the needs of their population.
The core purpose of an Integrated Care System is to:
- Improve outcomes in population health and healthcare
- Tackle inequalities in outcomes, experience and access
- Enhance productivity and value for money
- Support broader social and economic development
Integrated care is about giving people the health and care support they need, joined up across public services.
The Health and Care Bill, which is currently making its way through the parliamentary approvals process, is intended to further support the development of Integrated Care Systems, and make it easier for partners to collaborate to improve health and care for residents.
The Bill will establish ICSs (which are currently informal collaborations) as statutory bodies. The functions currently undertaken by Clinical Commissioning Groups will transfer to ICSs.
A key aim is to build on and further strengthen local collaboration between partners to address health inequalities, sustain joined up, efficient and effective services, and enhance productivity.
What does this mean for Hampshire and the Isle of Wight?
There have been some big improvements in health and social care over the last 15 years. For example, people with cancer and heart conditions are experiencing better care and living longer. However, people’s needs have changed and they are generally living longer. They want their health and care services in a place and at a time that is right for them. For many, this means care that is provided at home, or in local healthcare centres - not in a hospital.
At the same time, people in Hampshire and the Isle of Wight are waiting longer for treatment and spending lengthy periods of time in hospital when they could be at home, or seen by their GP or at a local healthcare centre.
Things can also seem unnecessarily complicated sometimes. For example, people having to repeat themselves to doctors, nurses and care workers and sometimes having to go to lots of different appointments in different places. This could work better and services could be more joined up and easier to understand and use.
There are some big staff challenges that we need to deal with. Even though in recent years the number of qualified clinical staff in the NHS rose by 3.9 per cent, there are not enough nationally for some services.
We’ve got some tough financial pressures too, which is mostly down to increased demand on services and people living longer. It’s a amazing thing that so many people are living longer, but it means the way we work needs to change to meet the needs of an ageing population, so they can live well.
Health and care partners in Hampshire and the Isle of Wight have a long history of working together. Over the last four years NHS and local government organisations have continued to join forces to tackle the historical challenges that had been difficult to solve by working separately. Leaders are trying new and different approaches to tackling these issues and we are beginning to see real improvements in the services we offer our population as well as our financial performance. We are focusing on projects where we can take advantage of economies of scale, share expertise or make better use of our finite resources.
What are our local challenges?
Why do we need to change what we do?
At the moment we work primarily as organisations, leading and managing to deliver on our own priorities, as opposed to focusing on wider changes. This means that we have issues such as fragmented services and limited integration with non-health partners such as our local authorities and the voluntary sector much of which is based on a reactive approach to treating patients' needs rather than proactively planning and supporting their wellbeing.
While we have collaborated as a system for several years, we need to ambitiously transform the way we deliver care to be sustainable and overcome the barriers we face.
We are committed to transforming services and doing things once, where it makes most sense. We are also clear, however, that care should be delivered as local to individuals as possible, with the needs of local communities central to our planning.
Over the last few years, we have experienced significant challenges in providing the care that local people deserve.
Some of our key challenges are that we find it difficult to ensure people are seen within four hours at our A&Es, people are waiting longer for both inpatient and outpatient appointments, and we have a lack of capacity in community services.
Our local system has faced financial challenges and, in 2018/19, had a deficit of £59m. Over the coming years, we expect both our overall population size and the cost of care to grow, so we will not have enough funding to maintain our quality and access levels. We therefore need to look at how we work, what we do and how we fund our services to try and minimise the impact of the shortfall in funding.