Integrated Care Systems – welcome to the nightmare?  Finding hope: don’t do it alone.

This summer saw the go-live of new statutory ‘Integrated Care Systems’ (ICSs) from 1st July 2022 – arguably the third great revolution following the 1948 launch of the NHS, the introduction of general management and the internal market in the 1990s.

It represents the dismantling of the ‘internal market’ established by Labour governments in the 1990s and developed under Conservatives in the decades since. The formally declared core organising principle is shifting from competition to collaboration. But does this result in real change in health outcomes and people’s experience of joined-up care? Or will it, like so many top-down NHS reforms before, default to “just another reorganisation”?

The Statutory ICSs will be comprised of an Integrated Care Partnership, bringing together the NHS, local government, other partners, and an Integrated Care Board. Obviously, all this ambition for reform comes at a time of continued uncertainty and complexity with covid not having gone away, the backlogs in care, and the impact on staff. Whilst the scale of the care and health workforce and impending cost of living crises becomes clearer, this creates an inevitable ever-increasing pressure to do more with less.

So, it’s a challenging time for radically new leadership and governance arrangements to kick in. Over the next few weeks, I want to explore how the new systems can impact the patients and communities they serve.

The first challenge is ensuring the scale of the current and inherited issues doesn’t overwhelm the nascent ICSs and trap them in a ‘more of the same’ mindset and way of operating. How can the wealth of leadership and professional talent you see across every ICS be harnessed and empowered? How can leaders create what Margaret Wheatley calls an ‘island of sanity’? How can ICBs cast hope and ambition for their staff and local population?

My first plea: don’t rush in. Stop. Take a deep breath. The NHS and social care cannot meet the huge challenges alone, nor do they need to. You can’t do it alone. Build relationships and partnerships with local partners, including the local voluntary, community, and social enterprise sectors. The VCSE sector, for example, often has a huge range of untapped and often neglected resources of people, ideas and connections. Council partners – both upper and lower tier – have vision, passion and resources which can complement traditional health and care partners. Local patients and communities have assets, insights and strengths to bring.

You don’t have to do it alone.

1. Integrated Care Systems – Finding hope: a different kind of leadership.
2. Integrated Care Systems – Finding hope: Collective leadership
3. Integrated Care Systems – Finding hope: belonging
4. Integrated Care Systems – Finding hope: scaling up.
5. Integrated Care Systems – Finding hope: collaborating.