Integrated Care Systems (ICSs) must not become yet another NHS reorganisation to work around, chairman of the County Councils’ Network (CCN) has warned.
A new report into the progress of the new care systems found they lacked political engagement and were yet to deliver the paradigm shift needed to deliver local priorities.
And squeezed budgets, alongside pressure on services and a focus on top down targets, create a risk that Integrated Care Systems will fail to focus enough on prevention.
It comes as health secretary Stephen Barclay suggested top down targets could be slimmed down in favour of more local discretion. The move would be part of the review of ICSs to be carried out by former Labour health secretary Patricia Hewitt, which was announced in last week’s Autumn Statement.
Ms Hewitt, who is chair of NHS Norfolk and Waveney ICB, will look at the accountability and autonomy of the new systems.
The report, by consultancy IMPOWER, found less pooling of budgets now than in 2017-18, with councils claiming they were ‘very cautious’ about sharing resources while finances are stretched. Research found counties pooled £13.43 per-head this year compared with £15.56 in 2017-18.
Commenting on the report CCN chairman Cllr Tim Oliver said councils were ‘enthusiastic about the new regime, but he said: ‘There is a feeling from councils that there is too much focus on immediate and acute NHS pressures, such as hospital discharge and ambulance waiting times, rather than the preventative agenda.’
‘If the focus on immediate NHS pressures continues, then there is a high chance councils will view ICSs as simply another NHS reorganisation to work around.’
IMPOWER chief executive Sean Hanson said the report revealed a desire in local authorities and the NHS to ‘reduce health inequalities, boost preventative services and improve outcomes’, but he added: ‘There is concern that a lack of local autonomy and squeezed budgets will make it difficult to convert that desire into action.’
The report also found Just nine of the 91 Integrated Care Board members are councillors and the role of politicians in the system is still unclear.
Mr Hanson also warned: ‘Systems face two major tests in the coming months – winter, which will bring with it a national focus on hospital discharge, and budget setting for the next financial year. How ICSs emerge from these two tests is likely to prove the bellwether for future joint working.’
