As the largest of England’s 42 integrated care systems, responsible for more than three million people, North East and North Cumbria’s ICS is home to a range of significant health challenges, including what the ICS terms some of the highest rates of heart disease, liver disease and suicide in England.
The ICS has recently shared its new integrated care strategy entitled ‘Better Health and Wellbeing for all‘, which has the aims of reducing inequalities in life expectancy, ensuring fairer outcomes for all, offering the best start in life for children and young people in the region, and delivering all-around better health and care services.
Recognising the importance of developing strong and trusting relationships as the backbone for making improvements across the region, North East and North Cumbria’s new strategy draws upon the concept of knowledge exchange, sharing ideas and promoting ongoing learning. Setting up the ICS as a “system convenor” has been a “precondition for success”, North East and North Cumbria have said in a recent blog post, highlighting the importance of connecting people across the system with shared goals for improvement.
As part of this, the ICS has set up a learning community so that peers can come together to reflect and share judgements and uncertainties about practice, and share ideas or experience to collectively improve. “Establishing the learning and improvement community created the opportunity for sharing, collaboration and amplification,” the ICS says, “so that the sum of the collective could be greater than the parts and make a difference to more of our population.”
In order to create improvement across the system, the blog notes, the ICS must prioritise the building of agency. To achieve this, the ICS plans to engage leaders from all of its organisations to help create what it refers to as a ‘social movement’ that will have the impact of mobilising individuals region-wide.
Identified aims of the this movement are to give voice to those with less formal power within the system; to make learning and improvement the default approach to tackling key challenges; and to build collective capability in order to achieve better outcomes at individual, team, community and system levels.
In terms of implementation, North East and North Cumbria ICS will be working with the Health Foundation, from whom it has secured over £200k of funding to support this work, and an evaluation team from the University of Newcastle, in order to define and test measures of strategic impact such as growth of social capital and levels of engagement. This approach will feature bi-monthly meetings of an active steering group, along with representatives from across the system and their advocates, as well as leaders from the formal system.
On the 21st September 2022, an inaugural meeting of more than 200 people from across the region helped identify seven priority areas including mental health services for young people, safe transfers of care and shifting the balance from treatment to prevention. Three further Community of Practice Events were also held with a focus of learning together, focusing on enhanced clinical advice, handovers and urgent treatment centres.
In terms of measuring impact of system improvements, the blog reports that five interventions have already been piloted to support system priorities around urgent and emergency care, with early evaluation results “very promising”. For example, an intervention into 111 online and call answering capacity saw a 44 percent reduction in call answering time; there was a 64 percent reduction in minutes lost for ambulance handover delays; and a community calls service contributed to a six percent decrease in falls-related admissions to hospital.
“At the heart of our North East and North Cumbria learning and improvement approach is a focus on collaborative relationships,” the blog concludes. “Value will be created and breakthroughs (in thinking, practice and outcomes) made through the strength, number and quality of relationships in our system. Through the work undertaken so far we have learnt there is far more that unites us across a large health and care system than divides us and people are highly motivated to make a difference for the communities they serve.”
