Due to the lockdown measures, the move to Integrated Care Systems (ICSs) has been accelerated.

It is a strange paradox that the pandemic led to an increase in demand for health and care services and yet many of the services were less readily available. The reason for this was Covid-19 and the measures required to combat it. The strain on the National Health Service (NHS) was felt at various points during the past 15 months with continued fears that each wave of Covid-19 might lead to it being overwhelmed.

Thankfully, this did not happen but the necessary focus on coronavirus and its variants forced the arrangement of local health and care services to be reexamined. It became the task of individual communities to provide support and care for those who needed it most when the NHS was unable to do so.

What are Integrated Care Systems?

The term ICSs does not fully explain what the premise entails. The King’s Fund defines them as follows;

‘Integrated care systems (ICSs) are partnerships that bring together providers and commissioners of NHS services across a geographical area with local authorities and other local partners to collectively plan health and care services to meet the needs of their population.’

In fine, ICSs look to streamline the provision of healthcare by integrating local councils and services into the healthcare network. This means that, if the service works as intended, access to health should be easier as, rather than going through national platforms, those in need of the healthcare services can go to their local councils.

For example, if someone living in London requires a particular health service, the process of getting this care would begin with visiting the website for their borough. This provides a full list of services available within their local area. The resources on mental health services are a useful illustration of how ICSs function. The website provides links to established charities such as Mind or the Mental Health Foundation but also links to support groups in the local area and helplines if there is an emergency.

This example helps to conceptualise the premise of ICSs. Their goal is stated by the King’s Fund;

‘The central aim of ICSs is to integrate care across different organisations and settings, joining up hospital and community-based services, physical and mental health, and health and social care.’

In this vision, all areas of health and care are interconnected through the local services. Rather than having various, disparate areas of care, the whole collection of services form a single cohesive unit that begins at a local level.

Is this a new idea?

In short, no. A fresh vision for the future of health and care was conceived in 2018. The argument for this was that, following a marked improvement in public health over the past 100 years, the progress has been somewhat stagnant since the 1990s. This is most apparent in how people live with illness and disease. To that end, a change was needed and it came in the form of ICSs.

Since their inception, ICSs worked to forge closer relationships between local councils and the wider NHS as a whole. All of this was beginning to be implemented before the pandemic struck. Although the chance to expand and improve ICSs was brought by the pandemic, it nevertheless promises to have a long-term impact on the future of health and care.

The NHS Confederation stated their hopes and aspirations for ICSs in the post-Covid world;

‘Health and care leaders are keen to explore this new relationship and the opportunities to create a new ‘deal’, whereby people are active and engaged partners in the development of healthy places, not merely consumers of NHS services. A new relationship based on meaningful patient and citizen engagement, informed by community insights and underpinned by trust.’

If this vision is actualised, health and care in the coming years will be based on both a collaborative and a symbiotic relationship between the NHS and local councils. This will also allow responsibility to redistributed amongst the community.

The accelerated development of ICSs can be seen through the NHS Volunteer Responders programme which forms part of the Royal Volunteer Service. The people who offer their services for this programme during the pandemic have worked to help people avoid busy places by collecting their shopping, medicines and other important items, have regular contact with other people by making regular friendly phone calls, get to medical appointments by giving lifts.

What is the future of ICSs?

It is the hope that, with the help of ICSs, the community will become a vector for change in the healthcare system. Now, legislative changes have been introduced to ease the process of expanding and improving ICSs. These have a particular aim of increasing integration and collaboration. Indeed, it is these two features that underpin ICSs as a whole. No longer is the future of healthcare a case of the NHS or nothing. Instead, it is a collection of bodies that create a sprawling health network.

However, to ensure that these changes last and that the future of ICSs is prosperous, the legislative changes include the introduction of statutory bodies. These bodies will be accountable to NHS England and will be responsible for strategic planning and allocation decisions. The ICS health and care partnership is also being introduced will be responsible for bringing together partners with the hope of promoting partnership arrangements and developing a plan to address the broader health.

These changes speak to the potential of ICSs. As the world adjusts to life after a global health crisis, it appears that ICSs will form a large part of the post-Covid future. With their focus on collaboration and integration, ICSs will be at forefront of British healthcare.

About the Author: James Hingley

James Hingley is a contributing Features Writer with extensive expertise in International Relations, Politics and Culture.