Coventry and Warwickshire ICS has published their integrated care strategy, setting out the ICB’s vision for improving health and care services over the next five years.
They begin with the following pledge: “We will enable people across Coventry and Warwickshire to start well, live well and age well, promote independence, and put people at the heart of what we do.”
The document identifies four key ways through which the ICS will facilitate change and improvement on a broader scale. They will work to improve outcomes in population health and healthcare; to tackle inequalities in outcomes, experience and access to services; to enhance productivity and value for money; and to help the NHS support broader social and economic development.
Improving health and care through integration
The strategy acknowledges the need to target resources where they are most needed as a major factor in combatting health inequalities. There will be a focus on connecting services not currently working together, and building strong relationships within the community, in order to help create inclusive, responsive and localised support.
The ICS will look to offer better training and opportunities for their workforce, whilst simultaneously supporting the voluntary and community sector. They will expand information sharing across various sectors in order to use the insight gathered to set up preventative measures, with the aim of ultimately improving health outcomes throughout the population.
From a financial perspective, the ICS will combine finance and back-office systems in order to procure higher value services.
The focuses on three main priority areas which the ICS will work to address over the next five years; here we will explore each of them.
Priority one: prioritising prevention and improving future health outcomes through tackling health inequalities
In order to reduce health inequalities, the ICS will ensure all system partners have a shared understanding of the existing health inequalities, how they relate to their work and how best to address them. One example of this is using HEAT (Health Equity Assessment Tool) and supporting the personalisation agenda at a population level. They will also look to align service provision and preventative activities with intelligence around the wider determinants of health.
The strategy also refers to “proportionate universalism” – a gradient approach which will involve shifting resources to underserved groups and those with the greatest need.
With regards to prioritising prevention, the ICS’s system approach is based on the population health model, examining the cultural, economic and behavioural elements which influence the wider determinant of health within communities.
Both of the Coventry and Warwickshire Health and Wellbeing Boards have health and wellbeing strategies in place, focusing on safe, sustainable and connected communities.
The document makes reference to the global threat of antibiotic resistance, which is being treated as a priority through the Antimicrobial Resistance (AMR) Strategy. The AMR strategy is delivered in partnership with ICS colleagues and system prescribing leads – aiming to reduce inappropriate prescribing across primary and secondary care.
The ICS will adopt a ‘Health in All Policies’ approach throughout the system which will involve organisations promoting health and wellbeing policies -supporting people with the rising cost of living.
Relevant health partners across the ICS will coordinate effectively to ensure refugee, asylum seeker and migrant populations can access and receive tailor physical and mental support across all services.
In order to give children the best start in life, the ICS is working to implement the Child Health Integrated Learning and Delivery System (CHILDS) framework for integration; applying a population management approach to their health and care provision for children and young people.
A process of collecting and sharing insight into the health inequalities, needs and experiences of young people will be established to inform better service provision and preventative measures going forward. Services will be co-produced with children, young people and their families in order to play the local voice at the heart of decision making.
The ICS will pool resources through joined up planning and integrated working which will encompass children’s services and education, maternity and pre-maternity care, peri-natal mental health, early help, disability and special educational needs.
Priority two: Improving access to health and care services
The ICB aims to embed personalised care across the ICS, seeking to better experiences and health outcomes whilst reducing health inequalities by “focusing on what matters to people, taking into account their circumstances” and enabling them to live healthier lives.
The strategy sets out their plan to achieve this by supporting trusts, place partnerships and primary care colleagues in identifying opportunities to embed personalised care approaches; evaluating the impact for people and the larger system; supporting the workforce through training; and establishing a clear vision of what personalised care means, developing working practices to support implementation.
To improve access to primary care, the ICS will support PCN development and work with them to refresh their Primary Care Strategy in the context of the ICS. They will work with local out-of-hospital service providers to take a more proactive and preventative approach.
Three community diagnostic hubs will be established across Coventry and Warwickshire, alongside the development of the Primary Care Collaborative.
The ICS will also engage with local stake holders to invest in the community and voluntary sector, develop a framework for collaborative working and promote cultural change across the ICS.
In order to improve efficacy and efficiency of integrated services, the ICB will look to develop strategic leadership capabilities, putting in place the right governance and structures to optimise activity.
They will aim to create more opportunities for collaboration, “removing barriers to integrated care” and empowering staff and communities to deliver the changes needed within the system.
Priority three: tackling immediate system pressures and improving resilience
The two key areas of focus in this priority are supporting people at home along with developing, growing and investing in workforce, culture and leadership.
In order to support people at home, the ICS will work stem the flow to hospital settings and focus on re-abling people “to regain independence.” A further development pathway will be implemented in Warwick, which will enable all people in an acute hospital to access intermediate care services upon discharge.
The ICB will support informal family carers, who are an integral part of the care system in terms of supporting more people to be independent at home.
The ICB is currently updating their People Plan in line with the NHS People Plan, focusing on sharing learning, quality improvement, safety, networking and developing leadership across all services.
They will work with Anchor Alliance partners to improve employability for the their population, with an aim to improve access to training, education and employment for vulnerable residents alongside local university partners – developing education pathways for the future workforce.
The ICB has identified the key enablers to support the delivery of these priorities, including finance, digital and data, public estates, performance and assurance, quality and transformation and innovation.
By focusing on these enablers, the ICB expect to see an improvement in health and wellbeing, reduced inequalities in health and a better quality of services across the population over the next five years.
The document states: “We plan to develop a core set of high level metrics for each of our priorities so that progress against intended outcomes can be properly monitored… As we monitor our impact and hold ourselves to account for the delivery of this strategy, we will also draw on stories and lived experiences from the people we serve, to understand where we are making a difference and where there is more to be done.”
To find out more about Coventry and Warwickshire’s ICS strategy, please click here.