Healthcare – The NHS and Integrated Care Systems
April at BidVantage is all about Healthcare. We’ll have a series of blogs across this month, as well as a special guest for our end-of-month webinar. Today’s blog is a bit of an introduction to the NHS and Integrated Care Systems.
The NHS
The NHS is the publicly-funded healthcare system in England, providing comprehensive medical services to all legal residents free at the point of delivery. Established in 1948, the NHS has evolved over time but remains true to its founding principles of providing universal healthcare based on clinical need rather than ability to pay. The structure of the NHS is complex, with numerous organisations at the national, regional, and local levels working together to deliver services. At the national level, the Department of Health and Social Care oversees the NHS and sets overall policy. NHS England is responsible for setting priorities, allocating funding to regional bodies, and commissioning some specialised services.
Regionally, integrated care systems (ICSs) are responsible for planning and coordinating care across a geographic area. ICSs bring together NHS organisations, local authorities, and other partners to improve population health and reduce inequalities. Within each ICS, there are integrated care boards that oversee budgets and contracting, as well as integrated care partnerships that develop strategies to meet local needs. At the local level, NHS services are delivered by a range of organisations including Primary care providers such as GP practices, dental practices, and pharmacies
Secondary care providers including acute hospital trusts, mental health trusts, and community health services
Tertiary care providers offering highly specialised services
These providers work together in collaborative arrangements like primary care networks, which coordinate care for populations of around 30,000-50,000 people. In terms of the services provided, the NHS offers comprehensive care spanning:
Primary care including GP consultations, dental care, eye tests and pharmacies
Secondary care such as emergency services, planned hospital care, mental health services, and rehabilitation
Tertiary and specialised services for rare and complex conditions
The NHS also plays a key public health role, providing screening programs, immunisations, and health promotion initiatives. Overall, the NHS serves over 56 million people and handles over 1 million patients every 36 hours, making it one of the largest and most comprehensive health systems in the world. While the NHS faces ongoing challenges around funding, staffing, and meeting growing demand, it remains a source of national pride and continues to deliver high-quality care to the population.
Integrated Care Systems
Integrated Care Systems (ICSs) represent a pivotal shift towards a more collaborative and unified approach to healthcare and wellbeing across England. With 42 ICSs now established, this section aims to elucidate their structure, purpose, and the profound impact they are poised to have on health and social care landscapes.
ICSs are collaborative networks that bring together a wide array of health and care organisations, including NHS entities, local councils, and a diverse range of partners from the voluntary sector, social care providers, and beyond. Their establishment on 1 July 2022 marked a significant step in England's healthcare evolution, formalising partnerships designed to foster a more integrated health and care system. These systems aim to not only improve patient care but also address broader social determinants of health and wellbeing.
Objectives of ICSs
The core aims of ICSs include:
Enhancing population health outcomes.
Reducing disparities in health access, experiences, and outcomes.
Improving productivity and ensuring value for money within the healthcare system.
Supporting the NHS in contributing to broader social and economic development.
Key Components of ICSs
Integrated Care Partnerships (ICPs): These are joint committees running within each ICS, comprising NHS organisations, local authorities, and a broad alliance of stakeholders, including the voluntary and community sectors, social care providers, and other essential services like education and housing. ICPs are tasked with developing long-term strategies to improve health, social care services, and overall wellbeing in their respective areas.
Integrated Care Boards (ICBs): Operating as NHS organisations, ICBs are responsible for planning and managing health services for their local populations. Each ICS area has one ICB, which oversees the NHS budget and collaborates with local health service providers to formulate a joint five-year plan. This plan aligns with the ICP’s integrated care strategy, aiming to foster a cohesive approach to health and wellbeing.
Upper-Tier Local Authorities: These authorities play a crucial role in social care and public health services. They contribute to the overall health and wellbeing of the community by providing essential services such as housing, education, and transportation, aligning their efforts with the ICP’s integrated care strategy.
The Role of Partners in ICSs
ICSs are distinguished by their inclusive approach, engaging a variety of partners:
Voluntary and Community Sectors: Offer local expertise and support to community-based health initiatives.
Social Care Providers: Specialise in delivering care and support to individuals requiring assistance to live independently.
Other Sectors: Entities from housing, employment, education, and justice contribute to addressing the wider determinants of health, showcasing the comprehensive approach of ICSs towards improving community wellbeing.
Flexibility and Local Arrangements
ICSs possess the autonomy to tailor partnerships and service delivery to their unique local contexts. This flexibility allows ICSs to innovate in how services are integrated and delivered, ensuring that care is responsive to the specific needs of their populations. Place-based partnerships and provider collaboratives exemplify this approach, enabling the design and delivery of integrated services that are both efficient and effective.
Further Info
For more detailed information on the structure and locations of Integrated Care Systems and Integrated Care Boards, please refer to the following:
https://www.england.nhs.uk/system-and-organisational-oversight/system-directory/
https://www.nhs.uk/nhs-services/find-your-local-integrated-care-board/