Black Country ICP recently released its Initial integrated Care Strategy 2023-2025 across the established themes of “Healthier People – Healthier Places – Healthier Futures”.
In introducing the strategy, Jonathan Fellows, Interim Chair of the Black Country ICP and Chair of the NHS Black Country Integrated Care Board, gave the following overview of the strategy aims: “This initial strategy will help inform the Black Country’s Joint Forward Plan for the NHS, amongst other areas such as managing the impact of COVID-19 on health and care, renewing the focus on delivering against the broader commitments for the NHS and embedding a population health management approach within our local system. These areas of focus, align to the various health and care partnerships across the Black Country.”
Fellows also noted the importance of collaboration and partnership across the ICP in achieving the ambitions set out under the strategy.
“There is more for us to do as a partnership. We need to strengthen our vision and the measures by which we will judge success. We need to move onto the next steps of creating an appropriate sense of urgency in our work. Our governance arrangements have started well, and we will learn and adapt as we move forward. We can emphasise some themes more strongly – for instance, sustainability for individuals, families, and communities in the Black Country. We are also working towards improved co- production, building on the dialogue we have established with our communities, some examples of which we mention in this strategy.”
Context and challenges
The strategy sets out the context in which the new strategy is based, as well as the Black Country-specific challenges that it is intended to address.
As home to 1.2million people across four Local Authorities including the City of Wolverhampton, Dudley, Sandwell, and Walsall; the Black Country’s history is closely tied to industry, with the mining of coal, iron and limestone powering past heavy industrial development. Fast-forward to the present, however, and coal mines and heavy industry have given way to tourism as the major industry keeping wheels turning in the region.
Understanding the needs of the 1.2million residents of the Black Country is central to the strategys’ aims. In order to better assess these, each of the four Local Authority areas has been given a Health and Wellbeing Board, with these becoming an important part of the Joint Strategic Needs and Assets Assessments. The main challenges identified by these assessments include:
- A generally higher proportion of BAME residents (Sandwell 40%, Walsall 28%, Wolverhampton 39%, and Dudley 14%) than the national average of 14%, with inequalities being exacerbated by reports that BAME communities experienced a worse impact from COVID-19
- A high level of deprivation as the second most deprived ICS population in the country behind Birmingham and Solihull
- A percentage higher than the national average of children and young people aged 0-15
- Higher recorded prevalence of hypertension, diabetes, chronic kidney disease, chronic heart disease, cancers, respiratory illnesses, depression, and dementia
- Both child and adult obesity rates higher than the national average
- Lower healthy life expectancy than the national average for both men and women
The strategy reveals four main areas which were identified during a prioritisation process and review:
- Workforce: Recruitment, Education and Training
- Children and Families
- Social Care System
- Mental health and emotional wellbeing
“It is recognised that some themes are ‘cross-cutting’ such as the current cost of living challenges and on-going health inequalities which are seen to permeate the four priorities. Our understanding of these themes will be enhanced by work undertaken by the Integrated Care System Academy following consultation with partners. An updated strategy for 2023/24 onwards, will review and refine the priorities for longer-term development over the following ten years.”
Approximately 45,000 people work in the NHS in the Black Country, including around 35,000 in adult social care services in about 593 CQC registered establishments. In addition, 35,000 people work within Councils including those working in school age education.
“This creates significant influence on work connected to the wider determinants of health – education and skills, leisure, regeneration and spatial planning, social care support for children, young people, and families as well as adults and public health. Partners in the police, fire and rescue services, further education, housing, higher education add considerably to the resources committed to improving the lives of people in the Black Country. Over 4,000 voluntary, community and social enterprise organisations and groups in the Black Country add to this comprehensive resources.”
The strategy sets out plans to use these resources to deliver the strategy as partners at both a place-level and system-level. Work in partnership is already being done across the NHS Black Country Integrated Care Board; Black Country Integrated Care Partnership; Black Country Integrated Care Partnership Joint Committee; Place-based Partnerships; Health and Wellbeing Boards; Health Inequalities Partnership Group; and other relevant partnership groups.
In order to continue to build upon co-production, the Black Country Together Voluntary, Community and Social Enterprise Alliance presents a forum for the sector to work together and have their say, supported by local Healthwatch agencies.
Looking ahead, the strategy centres around a set of principles, which include:
- To use improvement processes to improve access and quality
- To ensure activity contributes to reduction in inequity of access and of inequalities
- To consider opportunities for finance sharing
- To encourage transparency and trust
- To embrace equality as partners
- To come together where outcomes would benefit from collective expertise or access
- To use opportunities to scale up and share good practice
“We also embrace the “80/ 20” approach which inspires us to focus on prevention and early intervention to avoid upstream costs. A stable workforce will be one aspect which helps us with that, and we are committed to that.”
The strategy will be developed toward a longer-term ten-year strategy over the next couple of years.
Future plans include the potential to move to a wider “Assembly” model, which allows people to come together across the region to share experiences and discuss future directions. The strategy also recognises the need to remain up-to-date with challenges and innovations as they emerge.
“We want to be innovative in our approach to help improve people’s experience of health and care. Therefore, we will embrace opportunities such as those found in digital resources which improve standards of care assistance.”
To read the strategy in full, please click here.