Delivering sustainable healthcare: exploring Nottingham and Nottinghamshire ICS’s five-year strategy

Nottingham and Nottinghamshire ICS has released its integrated care strategy for 2023-2027; charting the organisation’s renewed focus on “providing joined up services and improving the lives of all people who live and work in the city and county” over the next five years.

The strategy is based on three guiding principles: prevention is better than cure, equity in everything and integration by default.

There are four central aims:

Improve outcomes in population health

Aim one revolves around supporting children and young people to have the best start in life, whilst also working to ensure frail older people with underlying conditions are able to maintain their independence for as long as possible. The ICS states: “We will also maximise the benefits of working together across the health and care system to get good health included in every conversation.”

An example of this in action is Family Mentors, a home visiting service for families across the four areas of Nottingham who share advice and guidance around key child development outcomes. Small Steps Big Changes have recruited Family Mentors from local communities, people with lived experience of parenting to help to build “trusted relationships with the families they support.” Family Mentors can give advice and support on topics such as weaning, teething, breastfeeding, play and sleeping.

Tackle inequalities in outcomes, experiences and access

The ICS will focus their efforts on the 20 percent of the population that requires the most support “will also invest in prevention activities around issues such as smoking, alcohol abuse, being overweight and more.”

One of the ways the ICS are tackling these challenges is through an outreach nursing team who support housebound patients. The team ensure that people receive the same primary care services as everyone else, offering holistic support for vulnerable people including “long-term condition reviews, vaccinations and education around medicine.”

Jane Streets, community practice nurse, comments: “The biggest thing is the social and educational aspect. It’s important to have that face-to-face contact as we pick up things that we wouldn’t just over the phone. We can provide the whole range of nursing services that housebound patients would receive if they could attend their GP practice, ensuring they are not disadvantaged because they cannot get to the practice.”

Enhance productivity and value for money

In order to enhance productivity and value for money, the ICS will combine their recruitment efforts to move staff around the system “as well as pooling our expertise around data, analytics and insights.” They will also ensure that existing joint working programmes continue to deliver high standards of care and are working together to continually improve services.

The ICS presents a case study highlighting how joint working has helped reduce the amount of people in mid Nottingham from attending emergency departments with end of life care needs from 5,304 (2019/20) to 3,433 (2021/22).

In addition, the End of Life Together Partnership identifies people with various care needs and gives them an opportunity to plan advanced care to suit them, with the document explaining that “they have access to a multidisciplinary single point of access and are then linked to the most appropriate service, such as day therapy, carer support or hospice at home support.”

Support broader social and economic development

The final aim of the strategy involves working together as large public sector organisations with other partners, such as universities and the private sector to “maximise investment and grow jobs for our population.”

Looking at case studies, Nottinghamshire Healthcare NHS Foundation Trust has used the Green Impact sustainability initative to help “staff, patients and service users deliver sustainability improvements and help contribute to the Trust’s Green Plan.” The trust has been running the Green Impact for the last four years, including during the pandemic, and has involved over 600 staff and 250 patients in their work to improve sustainability.

Lynn Walker, head of sustainability, says: “Green Impact is a fantastic way to get involved in helping to make a different to environmental performance, deliver sustainable change and reduce our carbon footprint. Teams sing up to a toolkit make up of fun and engaging actions on range of issues including food, waste, energy travel and biodiversity, all of which support the Trust’s overarching aim of delivering sustainable healthcare.”

To learn more about Nottingham and Nottinghamshire ICS’s five year strategy, click here.