What is an Integrated Care System?
Integrated Care Systems are the future of healthcare. Integrated Care Systems (ICSs) allow true multi-agency care, seamlessly coordinating multiple different disciplines and specialties. An ICS allows for smoother interaction between primary and secondary care; GPs and hospitals, mental health services, medical and surgical specialties will all fall under a regional ICS to deliver joined-up care.
The development of ICSs was based on a practical appraisal of the way people access care – local and regional care providers being the most common port of call for anyone seeking care. An ICS can respond to regional variations in the needs of their population, tailoring healthcare provision to their population.
With seamless multidisciplinary care offered region-by-region, the development of ICSs also recognised that there is sometimes a need for people to access specialist services nationwide. Before ICSs, referrals across NHS Trust boundaries could be a bulky process; with an ICS, the process should be streamlined, and legislature surrounding health and social care provision will reflect the need for integration.
Modelling an Integrated Care System
Each ICS has a large population, and so health and social care assessment and delivery is subdivided into three broad levels within each ICS:
- System: the overarching management of an ICS – this level is responsible for strategy, planning, commissioning, audit and monitoring, performance and outcome management.
- Place: At a council or borough level, responsible for integration of local services, public health monitoring and promotion.
- Neighbourhood: integrating multidisciplinary care teams on an individualised basis, providing health and social care for the needs of the immediate population.
How many Integrated Care Systems are there in the UK?
As of April 2021, there are 42 Integrated Care Systems in England, developed by NHS England and NHS Improvement. Each covers a specific geographic area, and represents a collaboration of health and social care providers for that region. Each of the 42 ICSs is responsible for planning, assessment, funding allocation and all care provision for its own region. Each ICS is able to tailor provision to the needs of its population – the population numbers, density, distribution and needs is unique and diverse between, and within, each ICS.
The NHS for Scotland, Wales, and Northern Ireland have used integrated care models with unified local health boards and structural integration for some years now. Integrated Care Systems for NHS England has been developed with the lessons and benefits of the earlier models in mind. Although the models are not identical, having interoperable, ICSs across the whole of the NHS is a key feature of NHS planning.
What is the difference between an STP and an ICS?
A Sustainability and Transformation Partnership (STP) is a cohesive partnership of health and social care operations under a regional authority. They were created after the publication of the NHS’ ‘Five Year Forward View’, to streamline services both for providers and for those accessing care.
An Integrated Care System is almost a natural evolution of an STP into a fully integrated care model with local authorities, social and health care providers working together without the historical barriers between specialties. Integrated Care Systems emphasise partnership, collaboration, and flexibility – with a seamless service at the point of care.
An ICS places decision-making at a regional, local, and neighbourhood level, with decisions made by people who best understand the needs of their service-users and the health of the public. Levels of integration, strategy, financial and workforce planning are assessed and agreed to enable true integration or services as set by commissioners and partners representing all health and social care providers. A scalable model of integration ensures that flexibility is key, evolving to meet the changing needs of the people and the service.
Why Integrated Care is important
People are complex, and the health and social care needs of a population reflects that. Historically, individuals were served by a number of different, often overlapping, health and social care providers. Anyone might require input from social care providers, outpatient medical services, mental health care, be regularly seen within a primary care trust, have an admission to a local hospital, then a transfer to a different trust. Every one of these points of contact would be from a completely different authority. From a patient’s point of view, this involves a lot of repeated ‘first contact’ with professionals, lengthy referrals processes, and even delays in critical treatment.
With integrated care, the logistics of care delivery should not affect the people who need care to happen smoothly – the patients and the professionals directly involved in their care. An integrated care pathway should provide a smooth, seamless, person-centred and coordinated experience. The activities in the background – the wheels that make the NHS turn – clinical coding, funding, supply chains, tenders and the whole management structure are tailored to the needs of the actual local population. Local health and social care strategy is directed by those people best placed to understand the health and social care needs of the region.
ICSs can also improve data security; with regional groups making decisions about NHS strategy, interoperability of health records – both electronic and paper – means less duplication, more secure data transfer, and appropriate access to providers at every point of the patient journey.
Who is Affected by Integrated Care Systems?
All NHS bodies, including primary and secondary care trusts, mental health services, tertiary contracted services and more, will be working more closely with each other. NHS providers will also be working alongside local authorities and social care providers, including housing associations, schools, drugs and alcohol liaison services. The idea is to make the delivery of cross-discipline care seamless, so an ICS should mean that it is easier to work together for the health and wellbeing of individuals and the public.
Anyone accessing care should find that any cross-service needs, referrals and collaboration between providers is seamless. Patients should find that there is less repetition, less need for repeated initial assessments when moving between different elements of care, fewer delays and more cohesive interactions with services.
How Skills for Health supports Integrated Care
For nearly two decades, Skills for Health has been involved in the development and implementation of integrated systems for education, patient care, and workforce management. We developed technologies to help the NHS with integrated workforce planning. This includes a competency evaluation as well as a variety of educational and training tools, as well as auditable and renewable progress for personnel across all disciplines.
An electronic rostering system for medical professionals, nursing teams, and others, along with a knowledge of competencies and requirements, ensures that the appropriate people are in the right place at the right time. This is critical not only for optimal patient outcomes, but also for a positive worker experience.
Additionally, ICSs require planning and coordination, as well as collaborative decision-making, with the overarching goal of providing the highest quality care at both the local and national levels. Scaling up Workforce Planning for Integrated Care Systems with Skills for Health’s Six Step Methodology to Integrated Workforce Planning is a straightforward method for guaranteeing a scalable workforce with an appropriate skill mix.
More about Integrated Care Systems:
Skills for Health are dedicated to support the healthcare sector in implementing ICSs for enhanced workforce planning and improved patient care. Get in touch to discuss your organisational needs for integration and speak to one of our workforce experts.