Integrated care system Integrated care system

There has been a lot of discussion about how NHS organisations can work together to deliver required change. This is particularly so in relation to patient flows (how and where patients use services), clinical networks (how we share clinical expertise), and in relation to the strong partnerships that have been in place for many years across the region. 
As a result we have been thinking about how we could deliver the positive changes we need for our patients, and how planning for those changes would benefit from taking place across the whole North Cumbria and North East area footprint, working for people from North Yorkshire to the Scottish Borders.
NHS Hambleton, Richmondshire and Whitby Clinical Commissioning Group is working with partners across North Cumbria and the North East to ensure we can influence any proposed changes to the health system that may affect services used by our local population.
What are Integrated Care Systems?
Integrated Care Systems are not statutory bodies or organisations. Although they need clear leadership, decision-making and governance structures, they are essentially about individual organisations joining together to improve health and care. 
Integrated care means working together, focused on the same outcomes for patients, and often involves NHS organisations, councils and the voluntary or charity sector, in particular when providing care closer to home and tackling the causes of ill health. 
  • Integrated care systems (ICSs) are evolving and will lead and plan care for their specific population and provide coordinated leadership across NHS organisations. This involves where appropriate taking a ‘do once’ approach to joint priorities and pieces of work that are common to all organisations in the area.
  • Integrated care partnerships (ICPs) are alliances of providers and commissioners who are collaborating to deliver care. In North Cumbria and the North East to include parts of North Yorkshire, the proposal is for four ICPs to be in place, to run alongside a Cumbria and North East ICS, which will take responsibility for overall coordination in the whole geographical area, by April 2019. Health providers include hospitals, community services, mental health services, GPs, and independent and third sector providers. The ICPs will focus initially on bringing together enough critical mass to sustain vulnerable acute services within their geography, and the commissioning of non-specialist acute care. CCGs within these ICP geographies will continue to develop place-based arrangements for the planning and provision of primary and community care and health and social care integration, aligned to the overall ICS strategy.  
We aim to build strong collaborative relationships with patient groups, local Healthwatch and voluntary sector organisations operating across the region, including organisations and groups working with some of the most excluded and hard to reach communities. 
How have they come about?
Senior leaders and doctors from NHS organisations across North Cumbria and the North East including parts of North Yorkshire are working together regionally and locally to:
  • Plan and develop services to meet the needs of local populations from North Yorkshire to the Scottish Borders now and in the future – taking into account how services are currently provided and where they need to change or develop. In particular, where new models of care might need to be introduced to integrate what is provided and ensure patients are seen in the right place, by the right person to meet their needs.
  • Use information held by each organisation to ensure planning and development of services is based on patient and population need and available skills and resources.
  • Consider how the current and predicted NHS workforce affects the provision of services.
  • Look at services such as tests, scans, x-rays and other diagnostics, and how they could be provided in a more accessible and efficient way.
Initial thinking and priorities for this were outlined in Sustainability and Transformation Plans (now called Partnerships) published in the autumn of 2016. The partnership working that has evolved since then is focused on bringing about change in a number of areas. The rationale and context for making the changes is not dependent on organisational form however, a number of developments are taking place to ensure organisations are best aligned to support the changes, which are often needed across organisational boundaries.