1 July - Mental Health Network - Governance during the COVID-19 pandemic

02 July 2021

This week’s meeting was joined by Roger Davidson and Julie Das-Thompson from the System Transformation Team at NHS England to share the latest updates and next steps around the development of integrated care systems in England.

Roger told the meeting that NHSE/I is working to keep the bill timetable on track, as a new health secretary has started in post, and significant delays may well have implications for the wider timetable. The intention, he said, is to try and get a second reading of the bill ahead of the summer recess.

He said NHSE/I is working with the Department of Health and Social Care on the guidance in relation to integrated care boards and integrated care partnerships). They will be drawing heavily on NHSE and the LGA, and wider mechanisms, to ensure this partnership is right. Key questions are around the relationship between the partnership and the board and how they will both engage communities.

Richard also reflected on the ICS board, and how its make-up is challenging as they are trying to find a balance between an inclusive board which all parties can influence whilst also ensuring they are fit for purpose for making decisions. There will be (as a minimum) a chair, a CEO and finance director and independent non-executive scrutiny of this so there should be two independent NEDs alongside the chair.

There will also need to be strong clinical and professional leadership, including a medical and nursing director, which they will need to cover all multi-disciplinary professions and roles. There would also be three partner members, with one from an NHS trust, one from primary care and one from a local authority. All of these roles will act as a unitary board and fulfil the governance function of the organisation.

There will be other decision-making structures set up around this board, as well as at place. The partnership will be to provide integrated care in their locality and will involve all partners necessary in order to do this, and the legislation and guidance is permissive to allow for local determination. Options could include at place committees, individual directors, consulting body or lead provider arrangement.

On the transition process, the priority is getting the leadership in place, starting with the Chair. The role is slightly different from the current ICS Chair role, so there is a process to explore differences across the country and run recruitment processes where necessary. From there, chief executives can be appointed and they can then begin building their board ready for October.

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