Bristol, North Somerset and South Gloucestershire ICB discusses integration framework

NHS Bristol, North Somerset and South Gloucestershire (BNSSG) has released papers from their ICB meeting in February, wherein they discussed their ‘Healthier Together’ framework.

Here we will examine the key aspects of the meeting and the overall outcomes and objectives for the ICS moving forward.

Reflections on the ICB framework

To begin, an overview of the final framework document was provided by Colin Bradbury, director of strategy, partnerships and population, and Seb Habib, programme director.

The vision of the framework is described as “people enjoying healthy and productive lives, supported by a fully integrated health and care system; providing personalised support close to home for everyone who needs it.”

The papers note that the Health and Wellbeing Board is in the process of creating a solution to ensure that the framework is embedded within all partnership organisations, with the ICB chair also requesting that a tracking mechanism be included in the framework to reference the intelligence gathered.

All members acknowledged that the challenge lies in balancing existing locality strategies and the framework’s wider priorities -and that focus needs to shift to a resident centred approach that will benefit the public.

Processes to support the development and implementation of the integrated care strategy

Discussion turned to the development of a strategic approach across BNSSG in light of the partnership’s framework.

The papers state: “We are keen to test with the Partnership Board an assumption that in defining our ICS strategy we should not stop at aspirational or broad goals. Rather, to be impactful, our strategy should identify pivotal objectives that will drive step change improvements in outcomes; articulate the type of strategic change required to achieve pivotal objectives and test the feasibility of delivering such change; and commit to working in partnership to deliver the strategic change that is needed to achieve pivotal objectives.”

The board agreed that it is important that the system collectively designs a process which will act as a guide on identifying priorities within the overall strategy, adding that “whilst the priority areas are unlikely to be new, what will be different is a collective focus on a handful of key change programmes, rather than continually trying to improve all aspects of our system simultaneously.”

Roles and responsibilities

At this stage of the meeting, the ICB acknowledged that they are still developing structures and methodology to allow them to work effectively as a partnership to deliver the best health outcomes. This necessitates the building of consensus “as to where roles and responsibilities lie for the development and oversight of different aspects of the system’s strategy.”

This section includes a visual diagram of what the strategy will look like, breaking down the various roles into five components. It is available to view on page four.

A new relationship with the VCSE

The framework states that a new relationship with the voluntary, community and social enterprise sector (VCSE) is required in order to increase capacity, funding, knowledge and representation across the ICS.

The papers state: “In taking this forward it is important that we engage further with ICS partners, to identify opportunities to build on the existing work of local authorities and who is best placed to lead.”

The ICS will explore the potential of the VCSE to develop a strength-based approach, focusing on supporting residents to take a more active role in their own healthcare. They will encourage the VCSE to actively recruit from within the ICS’s deprived communities and develop a framework to ensure short term funding is effectively distributed.

The Strategic Intelligence Collaborative is to support the VCSE in capturing outcomes and demonstrate the value their services provide to the community. Non-recurrent funding will also be used where to possible to provide training and support for local staff.

Lastly, a system level VCSE representation model will be finalised to facilitate charitable funds from outside the ICS.

Proposed timeline

The board then illustrated a proposed timeline of the strategic framework and the actions discussed therein.

They noted that the aim to finalise objectives and the strategic development plan by March 2023 has been met. The second stage of the framework involves inviting sponsors to “champion proposals for improving outcomes” and developing priority outcome proposals.

Third on the agenda is embedding outcomes in “the governance, decision-making and the roles of Health & Care Improvement Groups (HCIGs).” A reporting tool is set to be developed alongside datasets for monitoring progress of system outcomes. Implementation of these objectives is set to take place in June 2023.

Delivery of the Joint Forward Plan is currently underway, which involves publishing plans for further development of the ICS strategy and “codifying strategic intent through System Partner Agreements.”

The ICS aims to publish an updated strategic framework by the end of 2023.

For more information on the ICB board meeting, please click here.