The latest on the Integrated Care System

The Integrated Care System (or ICS) is the biggest transformation in health for many years – and it arrived in Northamptonshire on the 1st of July 2022.

But what is it?

Integrated Care Systems were born from the NHS Long Term Plan. At its heart is the need for any health system to work more cohesively to ensure that the health needs of communities are met: It sounds simple in theory, and it’s as much about saving and redirecting resource to where its most needed as much as expending new funds. In addition, though, it’s about ensuring that the wider determinants of health are catered for, and that the health system engages with communities and tailors’ bespoke solutions that fit their needs: And therein lies a huge challenge, but one that might benefit the VCSE.

How will it work in Northamptonshire?

At its head lies the Integrated Care Board or ICB.  This is effectively the Governance function for the ICS whose responsibility it will be to deliver a 5 Year Health Plan for our communities.

Sitting next is the Integrated Care Partnership or ICP. The ICP is the Operational Board of the ICS and has responsibility for drafting the Integrated Care Partnership Strategy upon which the ICB will base its 5 Year Plan. The Independent Chair of the VCSE Assembly will represent the VCSE in entirety at this Partnership.

Below the ICB and the ICP is Point of Place Delivery which will be within the gift of 17 new Local Authority Partnerships or LAPS (9 in West Northamptonshire and 8 in North Northamptonshire). These LAPS will have a population size of between 30 and 50,000. Who sits where within these LAPS is still a point of debate, but it is quite clear that this is where the VCSE has most relevance and resonance because of our knowledge and experience in working directly with those communities.

Points for consideration?

The timelines to produce an Integrated Care Partnership Strategy are impossibly tight (December 2022) and are set by NHS Guidance.  The Strategy is likely to be a set of high-level principles which few people can argue with, and over time the Strategy will be developed within the LAPS. There is likely to be some limited engagement in September and October 2022, so watch out for this..!!

In addition, a Memorandum of Understanding needs to exist between the Integrated Care System and the VCSE which needs to be signed off at both the North and West Health and Wellbeing Boards. A copy of the proposed MOU can be found here: The ICS and the VCSE – the MOU | Voluntary Impact Northampton

Not every VCSE organisation will be able to sit at the LAPS: Each LAP will base its Priorities on Population Health Data for their Area and by choosing one or more of the priorities from a framework known as Live Your Best Life. The 10 ambitions of Live Your Best Life are:

·        Thriving Childhood

·        Access to the best available education and learning

·        Opportunity to be fit, well and independent

·        Employment that keeps them and their families out of poverty

·        Housing that is affordable, safe, and sustainable in places which are clean and green

·        To feel safe in their homes and when out and about

·        Connected to their families and friends

·        The chance for a fresh start when things go wrong

·        Access to health and social care when they need it

·        To be accepted and valued simply for who they are.

Because the system needs to report on Metrics, Metrics or Measurements will be set for each of these ambitions. This will be known as the Public Outcomes Framework. However, there may be some subtle differences between the North and the West and for organisations working across County you should be aware and looking out for these differences.

How a VCSE organisation sits at a LAP based upon Data and Priorities has yet to be determined but VIN as the NHS ICS Broker will be instrumental in helping to make these decisions.

The ICS is complex, and therefore Engagement and Feedback Loops for organisations across the piece (particularly those who are not sitting at the LAPS) will be crucial. VIN is proposing a VCSE ICS Designated Portal which will act as a One Stop Shop for all things VCSE ICS related, which includes Strategy formulation, minutes of Partnership Boards and a host of Engagement Resources.

The ICS has also identified 4 Clinical Priorities for Northamptonshire: These are: Children and Young People: Mental Health:  Ageing Well and Elective Care. The VCSE is represented on 3 of these through a collaborative approach in Children and Young People (through the REACH Partnership), Mental Health (through the Mental Health Collaborative) and in Ageing Well (through Northamptonshire Carers). As these are Clinical Priorities it stands to reason that funding will follow these.

However, the ICS is also about the Wider Determinants of Public Health and how this plays out within LAPS is still to be decided or seen.

How the Health System and Local Government will engage and tailor solutions for the community is also an unknown. This is new territory for Health (although GPS might call me to account on that point) and is often a limited exercise for Local Authorities. In this area the VCSE can be true partners and enablers.

LAPS will also need to understand what Assets already exist in their Areas (Buildings, Skills, and Organisations). If they don’t, they are likely to use a scarce resource in duplicating or replicating and existing programme. The VCSE has a key role to play in this Asset Mapping Exercise, which has been talked about for many years but has never come to fruition (probably because it’s a labour-intensive exercise to both do and maintain).

What’s Next?

Where the ICS starts is not necessarily where it will finish. At the moment it might appear imperfect in construct, and it will certainly need to be refined and developed over time. Most system leaders believe that We have to Start Somewhere, and in that VIN supports the process.

Watch out for more information on the ICS by regularly visiting our website and checking out the What’s New Section.