What is an integrated care partnership?
integrated care partnership (ICP) is a formal partnership of organisations (commissioners
and providers) working together to improve the health and care of the whole
population they serve. These are at sub Lancashire and South Cumbria level,
i.e. Central Lancashire, Fylde Coast, Pennine Lancashire, West Lancashire,
Weren’t these referred to as accountable care partnerships?
this concept was first introduced, it was described as an accountable care
partnership. More recently, the term integrated care has been used as it is a
better description of what we are doing differently. This was formalised within
NHS England’s planning guidance, published in February
included the announcement of the term ‘integrated care’ and has been
consistently used ever since in national strategic publications such as the Five
Year Forward View next steps and recent Long-Term Plan.
Why isn’t this ‘integration’ happening already?
barriers exist between professionals and services. Patients, staff and
organisations all feel these barriers at different levels, for example having
multiple appointments with multiple different services provided or commissioned
by different organisations. This makes the system confusing for patients and
also frustrating for staff. Whilst we can try to, as much as possible,
streamline our pathways and processes there some things which we simply cannot
do because of the regulation and necessary governance requirements in place
upon our organisations and services.
is no single model for how our partnership should be arranged – it is up to us
to determine the best approach to ensure the best health and care for our
population. While we have a clear vision
of what we want to achieve, we need to build on what works well here and
elsewhere to find the right approach for integrated health and care.
What will this mean for staff?
Staff will increasingly work more closely with
colleagues from other organisations. This should give health and care
professionals more time to spend with people who need their help by reducing
unnecessary duplication. Improved data
sharing and technology will support staff in their roles. New ways of working will create new and
flexible roles with development opportunities for staff.
Who is leading the Central Lancashire ICP?
have formed a senior leadership team from existing executive officers within
the partner organisations and are developing a shared approach to programme
management to monitor progress.
responsibility for monitoring of this progress lies with the Shadow ICP Board
which has been in place since April 2018. This board is supported by an
independent chair and ICP Programme Director. This board consists of senior
colleagues from the boards and governing bodies of partner NHS and local
authority organisations. Members leave behind their organisational allegiances
to take a Central Lancashire-wide population view, at all times putting the
best interests of local people first.
What does it mean to be in ‘shadow form’?
form means we are working towards being a full partnership. Organisations that are part of the ICP will work
together to use health and care resources in the best way possible. However
these individual organisations will remain accountable in their own right each
with their own board or governing body. Benefits of being in shadow form include
more freedom to make commissioning decisions, support from NHS England and NHS Improvement
and additional funding to support these improvements.
When will the ICP become a full partnership?
will be building the partnership through a number of phases over the next few
years. Unlike other NHS changes, the emphasis here is on finding local
solutions that meet our particular communities and requirements – rather than
implementing a top down restructure. This means that we are working without any
strict guidelines or requirements and the creation of a full partnership will
be at our design and pace. We are also
working within the current legislative framework – although there are proposals
within the Long Term Plan to review parts of current legislation, there is no
indication of when any changes may take place. However, we want to move quickly
and see progress towards a full partnership which includes integrated decision
making, budgets, governance, workforce etc, within the next three years. An
annual ICP Plan will set out what milestones we will expect to achieve towards
this within that year.
Are local authority partners on board?
with the commissioners and trusts, local authority partners (from Lancashire County
Council) are part of the senior leadership team and ICP Board which oversees
the partnership plans and decisions. Elected Members are represented on the ICP
Board via Councillor Shaun Turner. District Councils have one representative,
the Chief Executive Officer of Chorley Council who links into other officers
and members via the Central Lancashire Health and Wellbeing Partnership.
How will GPs and practices get involved?
and practices are already working together to improve the way in which services
are delivered. There are eight networks across
Central Lancashire (networks are clusters of GP
practices, working alongside community services within a geographical area,
covering populations of typically between 30,000 and 50,000 patients). A primary care
organisation which spans across all practices within Central Lancashire is
emerging and we expect in the future that this will be the vehicle by which the
CCGs will contract for services delivered to populations larger than a single
network/neighbourhood, for example all of Chorley and South Ribble or both
Greater Preston, Chorley and South Ribble. This organisation will then
represent primary care on the ICP board and could potentially hold a delegated
budget responsibility for all community and primary care services.
How will practices benefit from this/how will it change working for practices?
present practices are struggling to meet high demand. This means GPs and other
primary care staff do not have the time to spend with their patients to help
them better manage their health. Greater integrated working means that GPs and
primary care staff are part of a wider community support network which makes best
use of all resources available, including those in the voluntary, community and
third sector. This will help patients to stay well, manage their conditions
when they do become ill, use services appropriately when they need to and free
up GP time for those patients with more complex needs.
What mechanisms will be in place to make sure the partnership is held to account for quality?
individual organisations which make up the partnership will still be
accountable in their own right. Any
provider contracts which are commissioned either jointly between the CCGs,
local authority or by Healthier Lancashire and South Cumbria will still be required
to fulfil the requirements of the standard NHS contract. Commissioned services
will be subject to the same level of scrutiny as they currently are. In
addition, we’re continuing to work with NHS England and NHS Improvement to
develop governance and accountability arrangements so it is clear how decisions
are made and who is accountable.
Do we aim to make financial savings by setting up the integrated care partnership?
is no reduction to the funding we have available to spend on healthcare
services locally, so this is not about saving money.
are all living longer and often with more long-term complex conditions as a
result, meaning we require a greater input from health and care services for a
longer period of time. It is nobody’s fault but this inevitably creates extra
demand on services and the limited financial resources available.
demand is rising faster than our budgets are increasing, and so we are facing a
funding gap. In order to provide the best health and care system for people
living within Central Lancashire then we need to make the best use of the combined
resources available to us. That means considering what is best for the whole Central
Lancashire population and healthcare system rather than individual parts. We
can achieve this by better working together to improve quality and reduce
duplication. We are all responsible for ensuring we make the best use of the
resources available to us.
What do you mean by an integrated workforce?
integrated workforce is one that works more collaboratively so that the whole
team supporting patients are aware of their needs meaning that the right
professional can provide the right support at the right time.
example, network teams which are starting to operate across the area are made
up of professionals from across different organisations and services. GPs and
practice staff work alongside community nurses, therapists and wellbeing
workers who are all employed by the trusts as well as social workers who are
employed by the council. Working together as one team, the professionals put
aside their organisational allegiances to make sure that their skills and
expertise are used appropriately to meet all of the needs of the patients they
might mean sharing data where appropriate, and making better use of technology.
We anticipate there will be opportunities for staff through new roles and ways
What’s in it for staff? What’s in it for patients?
are lots of potential benefits for staff within this partnership. More
joined-up working with colleagues in other organisations means staff will not
be duplicating or repeating work and will have access to more information about
patients where this is necessary. This will give staff more time to spend with
patients and a better understanding of their needs and how they can be
supported. There will also be new roles and development opportunities for staff.
patients, they will be able to receive the support they need closer to home in
a community setting. This includes support to best manage their own health and
wellbeing. Patient choice will not be
affected. Patients will still have a
legal right to choose from a range of locally commissioned services.
Will it mean private companies can more easily get involved in the NHS?
is not about privatising the NHS. It’s about health and social care
organisations working more effectively together to make best use of collective
resources to benefit our local population.
the moment, the ICP partners include the statutory NHS and social care
organisations collaborating more formally. Overtime it is likely that we will
work more closely with other health and care organisations too, such as
out-of-hours or care home providers, for example.