The Department of Health and Social Care has published a paper following an engagement programme undertaken by the DHSC, NHS England and the Local Government Association on the implementation of integrated care boards (ICBs) and integrated care partnerships (ICP).
The foreword notes one of the aims is to ‘inform and shape conversations’, supporting local areas to find the arrangement that suit their populations and circumstances, rather than ‘imposing a one-size-fits-all model from above’.
The programme seeks to “address key questions and concerns” and share “emerging practice from local partners in developing their ICP”, along with providing an indicative timeline and next steps for ICP development in 2022.
The paper begins by outlining five expectations of ICPs that the engagement process was based on; they should drive the direction and policies of the ICS; be rooted in the needs of people and places; create a space to develop and oversee population health strategies; support integrated approaches and subsidiarity; and take an open and inclusive approach to strategy development and leadership, and utilise local data and insights.
Key findings across the five expectations confirmed strong support for community engagement, the ability of ICPs to bring together partners, and an open and inclusive approach to strategy development. The engagement confirmed the importance of ensuring that work at system-level complements and supports work at place-level. There was discussion around how to ensure representation for ICPs best-suited the communities and around the practical roles that ICPs could take, including advocating for new places and encouraging existing places to improve and innovate. Additionally, leadership and culture were raised as key factors, including who the ICP chair should be.
Between September and December 2021, the government engaged with a wide range of stakeholders to generate discussion around the aforementioned five ICP expectations. Topics raised included how to best approach the relationship between the ICP and ICB; how working in partnership will help to create an “efficient and sustainable” system; the desire for clarity on the structure and membership to the ICP; the importance of taking a wider perspective on population health; and the need for ICPs to work with places to agree on who does what, to avoid duplication.
Data and population health strategies
DHSC states that they expect ICPs to utilise local data and insight to develop their plans: “A good culture will be driven by an approach that is based on shared goals and evidence and is informed by the local communities that ICPs serve.” In relation to this expectation, DHSC notes that “successful ICPs will need to build a positive culture of inclusion and collaboration to achieve shared population health outcomes.”
The engagement exercise found support for the idea that the ICP will bring together the wider system of partners to address health inequalities in a joined-up, multi-agency approach. DHSC writes that, “This approach to joint working will develop proactive and preventative measures that turn the dial on population health, health inequalities and improve people’s overall experience of care and support.”
One of the set expectations includes the need for ICPs to create a space to develop and oversee population health strategies and the paper says that DHSC “expects the approach to be led by local data and evidence, as well as co-production with the wider health and care system and community representatives.”
In July 2022, DHSC plans to publish further guidance on the integrated care strategy building upon this.
Examples in practice
The document goes on to share findings from a number of case studies, with the aim of helping systems “reflect on their own approach and support productive conversations”. It shares examples of different models, including a collaborative approach between the local government, NHS and voluntary, community and faith sectors; a place-based partnership in which care collaboratives take responsibility to meet the healthcare needs of specific areas; and an approach which undertakes intense stakeholder engagement to explore options to develop the ICP.
DHSC summarise that “at the heart of our new systems, structures and constructs there must be a focus on communities and populations”; that wider determinants of population health (eg. housing, education and the green agenda) need to take a stronger, shared focus in the future; that they will be a key component in taking a population health improvement approach to reduce health inequalities; and that the ICP must “keep setting the tone of the partnership to continue defining that integration really means. If all partners engage in their most productive way, then anything could be possible.”
It also shares four thematic case studies that note the challenges faced and solutions to meet them, to “develop and drive forward partnership approaches” and to “provide some inspiration for areas as they consider the opportunities to improve outcomes and experiences that can arise from partnership approaches”.
To read the full document, click here.
