Integrated care…the first 100 days

10 October 2022

Senior consultant Mason Fitzgerald assesses the progress that’s been made in integrated care over three tumultuous months.

Sunday 9 October marked 100 days since the implementation of the Health and Care Act 2022 and the formal establishment of integrated care systems (ICSs) on 1 July 2022.

In that time there have been a number of seismic changes in the world, a new UK prime minister, and a deepening economic and environmental crisis that has profound implications for the health of our communities.

There is much to admire about how integrated care boards (ICBs) have gone about their tasks in the early days, with a sense of optimism in the face of monumental challenges, building on relationships and developing the partnerships needed to deliver the help and services that our local communities need. We also see a growing recognition among NHS providers of the system leadership roles they could, and should, play in order to meet system objectives.

GGI has reviewed the governance arrangements across the country’s 42 ICSs and watched and listened to their progress through our serious of networks, events and consultancy work. While every ICS has given their governance arrangements careful thought and planning, it’s no surprise that the early days of operating the framework have identified significant opportunities for further development and learning.

We are pleased to see that system leaders are open to reviewing their ways of working and making changes. It is important that governance arrangements support the system objectives and the desired culture and behaviours. Leaving it too late to change will result in entrenched positions and resistance to change.

The key questions for system leaders to consider at the 100-day point are:

  • Are we clear about the roles and responsibilities of all system partners and how decisions are made, and are they being made at the right level in the system?
  • Are we clear about how we are managing and improving quality, performance and risk, including the roles of all system partners?
  • Have we strengthened our relationships and partnerships?
  • Have we communicated well and engaged our communities in our work?
  • Do we have a clear sense of how we are going to measure success?

ICBs will do well to instil a culture of continuous improvement, and a review of the first 100 days is an important step in the journey to become a thriving ICS that delivers benefits for local communities.

GGI is currently working with ICSs to review their governance arrangements, and, through our networks and events, we are developing thinking on how ICSs should approach their first end of year review.

If you are interested in hearing more about how GGI can support you, get in touch.

Prepared by GGI Development and Research LLP for the Good Governance Institute.

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