Date published: 1 November 2021
Integrated Care Systems
Many people who work for the NHS will have been in meetings over the last few months where Integrated Care Systems (ICS) have been mentioned. It can be quite a complicated subject and I wouldn’t blame anyone, no matter what their role, for wondering ‘what’s all this got to do with me?’
I thought I’d use my monthly blog to explain how it will impact us all in the months and years ahead. The NHS is a massive organisation and, at times, it’s easy to forget the two most important groups it exists for – those who we care for and those who work within it.
According to a recent Kings Fund study, there were 564 million NHS patient interactions with GPs, community, hospital, mental health and ambulance services in 2018/19 , or around 1.5 million contacts every day. Since the COVID-19 pandemic, I suspect those figures have increased, but the level of service with each one of those patient contacts is often governed by geographical area.
As you can see in the diagram below from the Kings Fund some areas were hit harder by COVID-19 than others. Similarly, one area may be outstanding in its community or hospital services but is struggling to provide high quality mental health care, another area will be different again so it’s understandable why patients get frustrated at times. Why should one of your loved ones receive better care in one location rather than another?
A new Health and Care Bill, which is currently going through the Houses of Parliament before it becomes law, will set out changes to enable health and care organisations work together as never before. As part of that Bill, 42 ICS organisations will be formed, including Cheshire and Merseyside, which is one of the biggest in the country.
These ICSs will put the onus on NHS Trusts, local authorities and other health and care organisations to work together more closely, as we have done during the pandemic. This should enable care and expertise to be standardised across the region so there’s no disparity between levels of care depending on where you live.
Decisions will be taken closer to the communities they affect, using data and digital capabilities to understand local priorities and lead to better outcomes. There will be a better use of community assets and a greater focus on prevention and wellbeing.
At Mersey Care we've developed great partnerships for many years, for instance our triage cars with Merseyside Police, British Transport Police and North West Ambulance Service, our crisis lines and perinatal service with Cheshire and Wirral Partnership NHS Foundation Trust, our Integrated Care Teams working alongside local councils, GPs and the third sector and all the partners working with Life Rooms. Those are just some of the examples of how we work well with other local organisations.
So how will this affect those of you who help run our services, on the wards, in the community and in our offices? It can potentially lead to freeing up movement of staff, more flexible working and possible work development opportunities. In the community, our staff will inevitably workcloser with local councils and third sector partners, just as many of you have already during the pandemic.
Of course, working together in partnership can also provide differences of opinion or practice. Here at Mersey Care we pride ourselves on regularly reviewing the way we do things and look at more innovative ways of working, which we’ve done successfully with the acquisitions of Liverpool Community Health, Calderstones and North West Boroughs Healthcare in recent years.
Under the ICS system we will need to think and challenge our own organisational perspectives to operate within the system, but we will still retain our values, our responsibilities and accountability which I believe makes us a unique Trust.
Our services understand the communities we serve and are focussed. We will combine clinical excellence with prevention and integration in our services to improve the health of the people and communities we serve.
True system working will require high quality governance arrangements to support collective accountability, but not weighed down with red tape. It’s about building trust with our communities and all our partners working together with a shared vision and strategy.
There will be many NHS staff out there who may have experienced the journey towards Foundation Trust status, which was supposed to give a new level of freedom to operate, who may regard this as a step backwards.
I believe it’s a great opportunity for Mersey Care to help influence and shape regional healthcare both now and in the future. We’ll be able to share best practice, learn from each other and, most importantly, our patients, service users and carers should benefit from a more joined up approach.
We will remain true to our beliefs within the Trust and our governance and structure will remain the same, but I hope this is the start of an exciting era of partnership working that will benefit all.
Thank you all for your continued hard work and dedication
Prof Joe Rafferty CBE
Chief Executive, Mersey Care NHS Foundation Trust