News: Making Integrated Care Systems Happen

7 April 2021

The proposals for Integrated Care Systems (ICS) published to-date describe a dynamic, transformational programme for improving both quality and efficiency across NHS health and social care.  We have developed a set of Papers / Guidance Notes designed to help senior clinicians and managers working on ICSs to move to the next phase.

Each of the following Papers can be accessed here

Paper 1. Service Design and Delivery considers how it spans service requirements including ICS-wide acute services, integrated care and advanced primary care in a local Place. It draws upon information analysis derived from whole population management and identifies the potential for redesigning patient flows across the system.

Paper 2. Putting the Resources Required in Place : Workforce Finance and Estate focuses on the key enablers in the ICSs.  It considers workforce development, financial modelling and appraisal and optimising the estate within each ICS and how agreed measures are to be progressed with detailed implementation planning. 

Supplementary Paper 2.1 Best Practice in Workforce Development draws upon a new commission that we were asked to undertake by the World Bank in 2020/21. This required us to conduct an evidence review on best practice internationally on healthcare human resource planning and management. Drawing on evidence from  OECD countries we documented many examples of good practice that we found. The one crucial element of workforce development that falls short however, is requirements planning. Paper 6 offers detailed guidance and methodologies in workforce  planning as an aid to all organisations facing this particular challenge.

In Paper 3. Organisational Development we provide a working definition of the key components of an Integrated Care System (ICS). This draws on the prescriptions of current NHS England guidance and frameworks plus the findings from concurrent evaluation of the Pioneer ACOs in the US.  The most successful US pioneers have transformed quality of care whilst also reducing hospital utilisation and thereby containing costs. Finally, in the main body of the document we list the key components of success and propose practical solutions for implementing  each of these components.

In Paper 4 Population Health Management we look at how whole population health management can progress the objectives of Integrated Care Systems to extend integrated, pro-active out-of-hospital care and mitigate hospital utilisation. The approach we propose draws on current practice both within the NHS today, and international models that are delivering triple-aims outcomes today. 

Paper 5 Care Co-ordination focuses on more pro-active care for people with long-term conditions that is core to the ICS model.  People have differing levels of needs and thus need personalized support from health and social care. Conrane IHS has developed a toolkit to model the impact and guide the delivery of care coordination within a locality based integrated care system. This Paper draws on our experience of implementing effective models that deliver improved quality of life for patients, better value for money and staff satisfaction 

Paper 6 Applied Intelligence considers how we can use best in class health informatics tools to improve service delivery and our understanding of changing population health needs at various levels – from that of the individual to the General Practice level through to the whole health community.