Integrated care systems (ICSs) were given statutory powers and new legal responsibilities for the first time in July 2022 in UK.
These changes were intended to increase collaboration in the health and social care sector and to enable the NHS, local authorities and other partners to take collective responsibility for improving health outcomes, reducing inequalities, delivering better value for money, and driving local social and economic development.
This research examines the development of ICSs by assessing their efforts to develop system-wide approaches to the recruitment, training and retention of staff. Workforce issues such as these are currently some of the biggest challenges facing the health and care sector, and require a co-ordinated response from multiple organisations of the kind that ICSs were designed to enable.
Leading system-wide transformation is slow and the work is hard, but there are clear signs that progress is being made.
The research identified six distinctive ways in which ICSs are adding value: ◦ organising around a shared purpose ◦ building system leadership ◦ encouraging system-focused behaviours ◦ scaling and spreading success ◦ using resources more effectively ◦ managing complexity. The degree which this is happening varies across systems.
Despite signs of progress, there is a clear risk of ICSs going ‘off track’ as a result of pressures on services, intense political scrutiny, and extremely difficult economic circumstances – and the effect these conditions are having on the behaviours of leaders locally, regionally and nationally. There is widespread concern that ICSs may not achieve their full potential unless more is done to create an environment conducive to their success.
The research suggests that success relies primarily on supporting people to think, plan and act in ‘system-focused’ ways. If this is to happen, different behaviours are needed at all levels of the system. National bodies need to create a more enabling environment and ensure that accountability and funding mechanisms support system working. Local leaders need to model system working in their relationships with partners across the system.
There is considerable interest in how ICSs are performing and there is a danger that attention focuses on the things that are easier to measure. The research suggests that the less visible work of supporting people to work together differently is critical for success and must not be undervalued. The ability to do this well is one of the key factors that will determine whether ICSs succeed in delivering better population health and more joined-up care for people using services.
Photo Jordi Soldevila. Iteració de les portes tancades
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