Every area of England is now covered by an Integrated Care System, all at varying levels of maturity. The crux of this restructure is focused on bringing together key organisations in the health and care landscape, moving towards collaborative working at both place and system levels. Looking across the systems we support a number of key trends are evident:
- Integrated care systems provide the opportunity to put the patient and improving outcomes at the centre of decision making through a stronger focus on prevention and wellbeing and through increased use of technology such as virtual care delivery, clinical intelligence etc.
- Financial challenges (from the cost of COVID to the continually increasing demand for health and care services generated by an ageing population) mean that the integrated care agenda will require system leaders to develop a deep understanding of all elements of their system and focus on maximising the impact of every single penny of spend to build in long-term sustainability for place-based systems.
- Protecting the population, building resilience, achieving better health outcomes and reducing current inequalities are now more prominent concerns on the public agenda (and government priorities) which will be huge and complex challenges – but key ones for the sector to address.
- Using technology and digital tools to collect and analyse multiple sources of data (way beyond the existing datasets with which the sector is currently familiar) is going to be the bedrock to the next generation of technology-enabled transformation (e.g. Robotic Process Automation (RPA), AI, Internet of Things, Wearables, virtual care delivery and so on).
- Improving care and health outcomes, reducing inequalities and grasping the opportunities presented by digital technologies will only be achieved through a committed and skilled workforce - and this will be a key challenge for health and care systems.
- As the NHS currently accounts for 4% of the UK’s carbon footprint it will be a key player in the UK’s commitment to be carbon net-zero by 2050.
At SCW, we provide a wide range of support to ICSs and other health and care organisations locally (mainly in the South East and South West), regionally and nationally. We asked our customers about their development journeys so far and have summarised these into three key enablers that we think underpin the successful development of ICSs:
1. Building strong foundations
At the start of the ICS journey it is critical to get the basics right:
- Strong ICS leadership is essential. Accompanied by a strategic vision for collaborative working and ongoing transformation for the entire system.
- Trust and alignment among all the stakeholders are crucial. This is fostered by a transparent governance structure that enables evidence-based decisions.
- Developing a digital transformation plan centred on the patient journey through the ICS. This needs to be based on robust data on population, workforce, finance, quality, performance and outcomes.
- Providing an end-to-end view of the system to enable leaders to identify and address challenges, develop strategic plans and monitor progress through management dashboards at both a place and system level
2. Understand local data at ICS and place level to identify opportunities for improvement
- ICSs will benefit from access to large, comprehensive and integrated datasets. Analysis of this data will generate actionable insight - identifying opportunities for operational efficiencies, workforce development and design of new care models.
- This insight will inform the next generation of system-wide strategic commissioning. The new focus will be on understanding population health needs and identifying ways to best use system-wide resources to address those needs and improve outcomes.
- Data analysis will also help ICSs to better understand and address the major urgent challenges of a) clearing the backlog of elective procedures and b) handling the large cohort of long-COVID patients, through the development of new care models coupled with new technology such as Robotic Process Automation, AI, and wearables.
- ICSs will also have responsibility for ensuring that capital investment strategies are coordinated between different NHS providers, local authorities and reflect local judgments about the balance between competing priorities for capital expenditure.
- To maximise value for their populations ICSs will work with providers to set up provider collaboratives (vertically and horizontally) across their systems in ways that best reflect local needs
3. Be prepared to modify your transformation as expectations change
- There is no one-size-fits-all. Each ICS will need to look at delivery in their own system and ensure it is rooted in user-centred experience and the critical measure of outcomes.
- As ICSs take on whole population budgets they will increasingly determine how to use resources across their system. Key priorities will be to improve outcomes, address inequalities, raise productivity and impact wider social and economic development, including the carbon net-zero target
- Pilot care models will be refined and embedded as new sustainable models. Then further refined and developed over time in response to ongoing performance feedback and technological developments.
- There will be more focus on prevention initiatives as the integrated view of the patient and population outcomes becomes central to the strategy of the ICS. Constantly improving technology enables a variety of real-time patient-clinician interactions facilitating easy and secure access not currently available at scale.
- Tools and processes that aid the patient to navigate their journey through the system will become an increasingly important part of the patient experience and their satisfaction with it.
ICSs have the opportunity to transform the health and care system to improve efficiency and responsiveness to users' needs. They also have the opportunity to significantly improve the experience of staff, whose commitment and skills will be so central to the success in this endeavour.
These are really significant opportunities that ICSs have been designed to take, but we shouldn't underestimate the challenge.
At SCW we provide a wide range of support to ICSs and other health and care organisations who are transforming services and structures to address the fundamental challenges facing the health and care system.