North East London (NEL) ICP has released their interim integrated care strategy, which lays the foundations for NEL’s long-term collective ambitions. In the document, the ICP shares its aim to “work with and for all the people of north east London to create meaningful improvements in health, wellbeing and equity.”
It will do this by focussing on six crosscutting themes which will underpin the new ICS approach – focusing on “developing innovative and sustainable services with a greater focus on population health and tackling inequalities.”
The six themes are tackling health inequalities; improved focus on prevention; personalised and holistic care; co-production with local people; creating a high-trust environment that supports integration and collaboration; and working as a learning system, driven by research and innovation.
Alongside this, the strategy names four system priorities for improving care quality and outcomes: babies, children and young people; long-term conditions; mental health; and local employment and workforce.
Tackling health inequalities
In order to tackle health inequalities, the strategy highlights that key area for systemic action is, first and foremost, applying a “poverty lens” to their work.
This involves paying close attention to the health and social needs of people living in poverty, assessing their access and usage of services and identifying the wider determinants affecting health and wellbeing in order to address their unmet needs.
Secondly, they will place a strong focus on cultural competency through the “measuring and addressing” of ethnic disparities across health and care (i.e. waiting listings) in order to establish trust with these communities and to proactively tackle racism in order to ensure equity for all.
Other areas of action will include strengthening support for carers through their ongoing priorities and wider transformation programmes; ensuring accessible, appropriate and effective services for people with autism and learning disabilities; increasing the delivery and quality of annual health checks and vaccinations; collaborating to improve health and care services for people experiencing homelessness and reduce their mortality rate; and reviewing and analysing the impact of place-based partnerships in receding health inequalities, along with investing in scaling up good practice.
Prevention
The ICP is committed to steadily increasing their budget for prevention and early intervention over time, across both primary and secondary care. They will ensure all partners are supported by population health management, encouraging provider collaboratives and clinical networks to sharpen their focus on secondary and tertiary prevention.
The document states that “there will be a greater system role in tackling poverty and promoting social and economic development” – looking at increased employment opportunities for local people, through their network of anchor institutions.
Improving methods of data collection to identify areas of need is another key goal, particularly among those living in poverty, people from ethnic minorities and other priority groups.
Personalisation
In this section, the strategy touches on the “strong foundation for personalised care” the ICP has developed over the last three years.
The ICP will aim to expand upon this work by making sure that all social prescribing teams have access to digital templates in primary care, and by developing shared digital platforms and solutions for other personalised care interventions. They will implement personalised care ‘minimum data-set’ in social prescribing teams to evaluate impacts on wellbeing measures, and collaborate with PCNs and place-based partnerships to support ‘targeted social prescribing for identified cohorts including vulnerable people’. In addition, the ICP will increase access and support for underserved groups, support the development of new specialist roles in response to population health needs, and invest in social prescribing ‘community chests’ to increase resources in the local community and voluntary sector. Finally, they will support place-based partnerships to expand their health budge offer according to local need
Co-production
The strategy says that a shared commitment to co-production and “meaningful participation with local people, communities and partners” is at the heart of the system. This will involve sustained commitment to placing people at the centre of their work; from planning and service design to participatory budgeting.
This involves collaboration at all levels; working together to share resources, insights and build on best practice together in a supportive and nurturing environment.
The ICP will gain insight and evidence based on local feedback, strengthening the use of the NEL community insight system as a valuable open resource for all partners.
The Accessibility Champions Programme will work with the ICP to ensure all local people have access to participation in community projects, discussions, plans etc. In addition, there will be increased responsiveness to local voices and the development of a reciprical approach to partnership.
High-trust environment
A mutual accountability framework is currently being co-designed to facilitate engagement and improved behaviours across the system; identifying new ways for the multiple partners to work together to deliver the ICP’s ambitions to local people.
The ICP will continue to invest in the cultural and behavioural development of the system, ensuring that they collectively make good use of the opportunities available to them.
From a broader perspective, the strategy will focus on supporting the development of current and future clinical and care professional leadership whilst simultaneously promoting a culture of inclusion and diversity across their talent pipeline.
A learning system
As part of NEL’s continued mission to look for new ways to improve the quality of care for local communities, they are currently leading research with Barts Life Sciences – a partnership between Barts Health and Queen Mary’s University – to create new innovations that could benefit the local population and the wider NHS.
The strategy describes plans to give patients, carers and clinicians involved in the care of a patient (with their consent) better access to their care record. Alongside improved data and insights to give teams easier access to population information, which will help identify cohorts who would benefit the most from interventions.
Other areas of focus will include growing analytical capacity and capability to ensure teams are collaborating effectively with clinical direction; increasing innovation using evaluation to measure the impact they have and to support rapid scale-ups; establishing a clear methodology across the entire system for learning and improvement; and improving and refining research strategies to ensure they are asking more of the population the most important questions.
Four system priorities
The second main focus of the strategy revolves around improving quality and outcomes by tackling inequality across the local population. Below, we summarise the four system priorities outlined in the document.
Babies, children and young people
In order to provide young people with the best start in life, the ICP will need to create a safe multi-disciplinary learning environment across all NEL teams; work with place-based partnerships to increase support for the most vulnerable children and their families; develop clearly defined prevention priorities and community-based care; improving the access and support available for children as they transition into adulthood; and prioritising children and young people’s mental health.
Long term conditions
In order to improve services for the two thirds of North East London’s cohorts suffering with a long term condition, the strategy identifies a need to coordinate care more effectively. This will involve more consistent communication, investing in and empowering local communities and voluntary organisations, and increasing opportunities and support for healthier choices in local communities.
In addition, the ICP seeks to improve end-to-end pathways including secondary prevention, quality of care and implementing health improvement programmes, along with strengthening support for people with long-term conditions who are affected by poverty. They also aim to proactively support informal carers and recognise their contributions to the health, wellbeing and independence of local people.
Mental health
Ensuring the positive mental health of the wider community is a core component of NEL’s strategy, highlighting the need to embed and standardise their approach to peer support so that it is “valued and respected as a profession in its own right.”
This will involve placing what matters to service users and carers at the centre, enabling and supporting lived experience leadership and improving cultural awareness across NEL.
Providing carers with the support they need and improving peoples’ experience of accessing mental health services more generally is equally important. Understanding and acting upon local mental health priorities through engagement with communities is vital in assessing the needs, aspirations and inequalities facing specific groups of the population.
Local employment and workforce
The fourth system priority centres around developing a one workforce approach across health and care in NEL; working together to employ more local people and prioritise staff retention. They will achieve this through recognising and celebrating the social care and voluntary workforce, ensuring they feel equally valued for their contributions to the community.
The ICP is committed to becoming a Living Safe system, supporting the health and wellbeing of staff and ensure an efficient, streamlined and accessible recruitment process which promotes diversity.
The strategy also describes the continued development of a new ICS clinical and care professional leadership model which aims to increase diversity and inclusion.
Looking ahead
NEL describes the interim ICS strategy as an “umbrella for the full range of strategies and plans across the partnership” – providing a strong point of reference for the ICP to work from, and measure their progress in anticipation of the ‘Big Conversation’ set to take place within the next few months.
For more information on NEL’s interim strategy, please click here.
