On 1 July 2022, Integrated Care Systems were formally established on a statutory basis.
Integrated care systems (ICSs) are partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area (NHS England, 2023).
This masterclass welcomed the panel of North West ICB Executive Leaders to discuss developments within the complex ICS landscape over the last 12 months.
Chaired by Helen Wolstenholme, Assistant Director, Partnerships and Support, ICS Network at NHS Confederation, and Helen Hunter, Assistant Director for Place, CS Network at NHS Confederation, the masterclass provided insights into how our systems are driving change and integration forward, along with a facilitated panel Q&A session.
The panel welcomed Graham Urwin, CEO at Cheshire and Merseyside ICB, Sir Richard Leese, Chair at Greater Manchester ICB and Kevin Lavery, CEO at Lancashire and South Cumbria ICB.
Within their short presentations, the panel recognised that ICSs bring a chance to do things differently within the region and across the country, highlighting key successes they have seen thanks to new ways of working and collaborating. There was also recognition for the population size and scale of the ICSs in the North West, and the challenges that come with this.
Graham Urwin, CEO of C&M ICB
To start discussions, Graham Urwin shared the four main outcomes he felt ICSs were established for:
- Improving health outcomes and healthcare
- Ensuring value for money and productivity
- Tackling health inequalities
- Contributing to the socio and economic impact within the communities we serve
He recognised that thishas been the hardest period we’ve ever had to work through with many contributing factors from over the years such as austerity, aftereffects of Covid-19, industrial action and impacts on social care. Graham acknowledged that time is currently focused on delivering today rather than getting upstream. He highlighted the importance of the shift in focus this needs for ICSs to make a positive impact and highlighted that this is “a chance to drive new level of collaboration in the NHS”. Graham highlighted the efforts that health and social care staff have made over the current period to overcome challenges and the priorities within GM to continue delivery of services.
To end, Graham shared a handful of achievements, such as the work with local authority and community partners to see the biggest improvement of early detection of cancer at stage 1 & 2 in any ICB, highlighting the strength of integration.
Sir Richard Leese, Chair of GM ICB
Handing over, Sir Richard Leese brought a different perspective, as Chair, and with a local government background. Similarly, he recognised the challenges the last 16 months have brought, and the impact that transitioning multiple organisations into one has had on delivery of services, staff and running costs. He also recognised the challenges with devolution and industrial impact alongside this.
However, he highlighted several key elements that are working well, including:
- All ten districts across Greater Manchester have strong relationships between health and local authorities.
- The quick formation of the GM Integrated Care Board with a clear and strong strategy.
- Review of governance arrangements and improved operating model.
- Primary Care Board development to the Primary Care Collaborative, including all 4 PC disciplines.
- The set up of an alternative provider collaborative including VCSC which now forms part of the governance structure.
“Working as a system we can see a whole picture and start to take action.”
Sir Richard ended his presentation by sharing one of GMs biggest successes; clarity of purpose and strategy with a clear delivery plan that has a broad range of partners and stakeholders to support it.
Kevin Lavery, CEO of L&SC ICB
To end the panel presentations, Kevin Lavery shared insights from Lancashire and South Cumbria Integrated Care System. Kevin shared some of the key challenges within the system that drive over 60% of the budget spend on delivering acute services. This included an ageing population, increased demand, Covid-19 and long Covid, poverty and cost of living crisis. Kevin acknowledged the scale of these challenges, but also the opportunities that come with that.
He acknowledged the financials challenges the ICS has faced and shared the changes that L&SC have already started to make to re-configure services, with improvements that need to continue over the coming years. He also acknowledged the need to invest in community and primary care setting, with innovative solutions such as virtual wards and hospitals. He shared plans for two new hospitals within the locality, and the importance of long-term planning to ensure activity keeps the system balanced.
To close, Kevin shared his vision for the future of L&SC ICS, including the importance of leadership capability and the focus on recovery to deliver at pace and do it well.
Following the short panel presentations, a facilitated Q&A session by Helen and Helen explored a number of key themes. The panel discussed data and how this can shape strategy; opportunities through delegation of functions and decision making and evolving; and maintaining integrated relationships to achieve change. To close this section of the masterclass the panel also welcomed questions from the audience.
Many thanks to our panel and facilitators for joining us for this masterclass, for openly sharing insights into the three North West ICSs and providing a thought provoking and honest session.
You can watch back the full masterclass recording here.