Bristol, North Somerset and South Gloucestershire (BNSSG) ICS has released their joint forward strategy, which outlines the ICS’s vision for the coming years. The strategy is centred around a mission statement of “healthier together by working together”. By following an “innovative and asset-based approach, BNSSG ICS commits to focusing its collective resources and attention on these priorities.”
The document primarily focuses on four key areas: improving outcomes, tackling inequalities, enhancing productivity and supporting broader social and economic development. In this article, we will explore the core elements of each outcome and the wider ICS objectives.
Improve outcomes
The ICS will aim to improve outcomes in population health by drawing focus to conditions at all stages of life, identifying where interventions can be implemented earlier to improve outcomes. This will involve better prevention of diseases and management of ill-health to ensure people are supported to be able to recover more quickly.
This ties in with the ICS’s ‘Ageing Well’ initiative, which takes an anticipatory care approach to population healthcare – allowing integrated models of preventative care to be embedded across care pathways which will help to reduce avoidable hospital admissions, in turn relieving pressure from ambulance and emergency services.
Additionally, they will use intelligence and evidence to identify pivotal opportunities to support people earlier to stay well – providing strength-based services based around the resources of the person and their community. This approach will be designed and delivered at a local level, involving patients in the co-production of their care services and pathways.
Tackling inequalities
BNSSG will continue to tackle health inequalities by providing proactive support for targeted groups to narrow the gaps in outcomes.
One of the main drivers of change across all the ICS’s objectives will be strengthening relationships with the voluntary, community and social enterprise (VCSE) sector and local organisations. By working together to identify vulnerable and underserved cohorts, the aim is to align resources and approaches towards a clear, shared ambition to ultimately improve health outcomes across the region. The strategy also refers to an “ongoing rolling programme development, with integration of strategic objective implementation and delivery into existing upcoming programmes.”
The strategy emphasises the importance of looking at the “wider determinants of health” such as quality education, housing, community relationships and access to safe environments with clean air and space to exercise. All of these components form the building blocks of health and the ICS recognises that they have an opportunity “given the multiple organisations that make up our partnership, to actively try and address these multiple needs together, through an integrated approach between health, care and wider services.”
Enhancing productivity and value for money
The strategy recognises that intervening at the point of crisis is “inherently less efficient” and uses a lot of resources which would better utilised elsewhere. As such, they will look to address variation, duplication and inefficiency across the system. The document reads that by “building on our understanding of pinch points in flow across our system to identify optimal investment and application of our shared resources” they will be able to maximise value and productivity.
“Workforce is the most essential factor in achieving our goals,” the document emphasises, citing an urgent need to improve staff retention and recruitment across the ICS. This will involve supporting the health and wellbeing of all staff and supporting the workforce to adopt innovation; which will facilitate the development of new roles and the use of technology to aid innovation.
The document also conveys a commitment to “using our power to support local community development through an asset-based approach. The NHS, local councils and our other partners are ‘anchor-institutions’ and need to be conscious in the way we purchase things and employ people that we can have a big impact on local communities.”
Support broader social and economic development
The ICS will use their collective purchasing power to maximise the amount that is spent locally, and build a support structure which invests in training and employment across the most undeserved communities.
The document states: “As well as making day-to-day incremental improvements to existing ways of working, system partners will work together differently, strengthening our collaborative and integrated culture. This will respond to our clear case for change.”
The strategy discusses its next steps, stating that engaging with partners and the public at large is a central goal along with creating opportunities to “have honest and robust conversations as we coproduce the strategic priority areas.” The ICS recognise that multi-level collaboration is imperative in achieving the outcomes they have set out in their strategy, which will form the basis of their actions going forward.
The document also highlights a need to “be brave and innovative.” As the issues they are facing are long-standing, the ICS acknowledges a necessity to be “open to innovative solutions and brave enough to test and try things. This will include emerging fields like genomics and new medicines.”
Other commitments and actions
The strategy lays out other key elements it will utilise in order to achieve the ICS’s long-term goals.
These include building on the work of Health and Wellbeing Boards and Locality Partnerships by drawing on strategic priorities these groups have focused on. This will be further enhanced by the ICS’s relationship with Bristol Health Partners to give an evidence base informed by research and innovation.
The ICS will be supporting the development of community-led improvements, taking a ‘bottom-up’ approach which brings local people along with them as co-collaborators and therefore involving them in structuring improved care pathways and services.
The document also states: “We will develop the role of the voluntary, community and social enterprise sector organisations as equal partners within the ICS. This will build on the 10 Principles that NHSE have set out.” This will run parallel with reforming their relationship with primary care – an intention they aim to achieve through the GP Collaborative Board, bringing together all GP stakeholders, and the establishment of the Primary Care Collaborative Board.
More broadly, the ICS aims to become a trauma informed system – “ensuring that our organisations are trauma informed and that trauma informed approaches and processes are embedded throughout all services and stages of life.”
This ties in with the overarching aim of viewing the “whole person” and not just the illness or concern in an isolated way; exploring the wider influences which shape physical and mental health throughout a person’s life and thus facilitating a more compassionate and comprehensive understanding of patient needs.
To read more about BNSSG’s Joint Forward Plan, please click here.