Select Committee · Health and Social Care Committee

Integrated Care Systems: autonomy and accountability

Status: Closed Opened: 6 Jul 2022 Closed: 15 Aug 2023 10 recommendations 20 conclusions 1 report

The Health and Social Care Committee has launched a new inquiry to consider how Integrated Care Systems will deliver joined up health and care services to meet the needs of local populations. Forty-two new ICSs were established with a statutory footing across England on 1 July. Integrated Care Boards, one element of an ICS, will … Show more

Reports

1 report

Title	HC No.	Published	Items	Response
Seventh Report - Integrated Care Systems: autonomy and acco…	HC 587	30 Mar 2023	30	Responded

Recommendations & Conclusions

7 items

3 Recommendation Seventh Report - Integrated Care System… Acknowledged

Integrated Care System targets should be outcome-based, with sparingly used delivery prescription.

Targets for ICSs set by DHSC and NHS England should be based on outcomes. There may be times when greater prescription around how targets are achieved is needed, but we believe this should be done sparingly.

Government response AI summary

The government acknowledges the importance of outcomes-based targets and agrees other measures may be needed. They describe a mixed approach to target setting, balancing national and local targets, and highlight existing commitments like the Levelling Up health mission and a reduction in national NHS objectives.

Read full response →

Department of Health and Social Care

12 Conclusion Seventh Report - Integrated Care System… Acknowledged

DHSC requires urgent clarity on providing advance funding information to Integrated Care Systems.

We welcome the Minister’s comments about giving ICSs information about the funding that will be available to them further in advance. DHSC must set out how it intends to do this, and any decision to give that information must be made in plenty of time to support ICS preparations for … Read more

Government response AI summary

The government provided a vague commitment, describing how a senior advisory group and system leaders are supporting the implementation and design of new initiatives, but did not specify how it would provide funding information to ICSs earlier.

Read full response →

Department of Health and Social Care

18 Recommendation Seventh Report - Integrated Care System… Acknowledged

Set out how to empower MPs to hold local ICSs accountable with performance measures.

The Secretary of State should set out further detail about how he intends to empower MPs to hold their local ICSs to account and what performance measures he envisages being available to support this.

Government response AI summary

The government offered a vague commitment, supporting the intent to empower MPs but stating that further work will be undertaken as ICSs mature to understand how it could be implemented, given their infancy.

Read full response →

Department of Health and Social Care

19 Conclusion Seventh Report - Integrated Care System… Acknowledged

Unclear monitoring and accountability mechanisms for partnership working in ICSs

Partnership working is fundamental to the design of ICSs and will be the make-or- break factor in their success. As we have discussed, the monitoring and evaluation of NHS priorities and structures is well established but it is unclear how partnership working will be monitored. It is also unclear how … Read more

Government response AI summary

The government made a vague commitment, stating that NHS England's new operating framework includes a commitment to collaborative working and that NHS England will work with ICB leaders to consider how to best support ICBs to mature.

Read full response →

Department of Health and Social Care

22 Conclusion Seventh Report - Integrated Care System… Acknowledged

Unclear how government will monitor professional representation on Integrated Care Boards

We have heard a range of compelling arguments for particular professions to have greater representation on Integrated Care Boards and are sympathetic to the concerns that have been raised with us about the exclusion of expertise. However, we are also sympathetic to the Government’s intention to give ICSs flexibility when … Read more

Government response AI summary

The government supports the Hewitt Review's vision for ICS ratings and states DHSC and CQC will work with partners to develop and start testing these ratings in 2024-2025, but does not specifically commit to monitoring professional representation on ICBs.

Read full response →

Department of Health and Social Care

25 Conclusion Seventh Report - Integrated Care System… Acknowledged

Good patient and carer involvement essential for ICS to meet local needs

The core purposes of ICSs, and the importance of addressing local needs, will not be met without good patient and carer involvement. ICSs cannot truly deliver for their local area without considering the needs of that area from the patient or carer’s perspective. (Paragraph 81) Integrated Care Systems: autonomy and … Read more

Government response AI summary

The government reiterated its commitment to the NHS Long Term Plan and various delivery plans aimed at addressing health inequalities and improving health outcomes, but did not specifically outline actions to ensure or strengthen patient and carer involvement in ICSs.

Read full response →

Department of Health and Social Care

26 Conclusion Seventh Report - Integrated Care System… Acknowledged

Opportunity to review Healthwatch funding and commissioning arrangements given new expectations

Given the new expectations that have been placed on Healthwatch organisations across the country, we believe this is a good opportunity to consider their funding and commissioning arrangements.

Government response AI summary

The government acknowledges the opportunity to consider Healthwatch organisations' funding and commissioning arrangements given new expectations.

Read full response →

Department of Health and Social Care

Oral evidence sessions

4 sessions

Date	Witnesses
7 Feb 2023	Helen Whatley MP · Department of Health and Social Care, Mark Cubbon · NHS England, Matthew Style · Department of Health and Social Care	View ↗
17 Jan 2023	Kate Terroni · Care Quality Commission, Louise Ansari · HealthWatch, Nicholas Timmins · Institute for Government, Sarah Walter · NHS Confederation, Zina Etheridge · North East London ICS	View ↗
6 Dec 2022	Andrew Lane · National Pharmacy Association, Dr David Wrigley · British Medical Association GP Committee, Dr Linda Patterson · Bradford District Care NHS Foundation Trust, Dr Trudi Seneviratne OBE · Royal College of Psychiatrists, Miriam Deakin · NHS Providers, Professor Jim McManus · Hertfordshire County Council, Professor Vic Rayner OBE · National Care Forum, Rob Darracott · P3 Pharmacy, Sarah McClinton · Association of Directors of Adult Social Services	View ↗
8 Nov 2022	Chris Hopson · NHS England, Councillor David Fothergill · Local Government Association, Patricia Miller · NHS Dorset, Professor Sir Chris Ham · NHS Assembly, Rob Webster · West Yorkshire Health and Care Partnership, Rt Hon Patricia Hewitt · NHS Norfolk & Waveney Integrated Care Board, Sir David Nicholson · Sandwell and Birmingham NHS Trust and Dudley Group NHS Foundation Trust	View ↗

Who gave evidence

24 witnesses

Witness	Organisation	Sessions
Andrew Lane · Chair	National Pharmacy Association	1
Chris Hopson · Chief Strategy Officer	NHS England	1
Councillor David Fothergill · Chair of the Community Wellbeing Board	Local Government Association	1
Dr David Wrigley · Deputy Chair	British Medical Association GP Committee	1
Dr Linda Patterson · Chair	Bradford District Care NHS Foundation Trust	1
Dr Trudi Seneviratne OBE · Registrar	Royal College of Psychiatrists	1
Helen Whatley MP · Minister of State	Department of Health and Social Care	1
Kate Terroni · Chief Inspector Adult Social Care, Integrated Car…	Care Quality Commission	1
Louise Ansari · National Director	HealthWatch	1
Mark Cubbon · Chief Delivery Officer	NHS England	1
Matthew Style · Director General for Secondary Care and Integrati…	Department of Health and Social Care	1
Miriam Deakin · Director of Policy and Strategy and Deputy Chief …	NHS Providers	1
Nicholas Timmins · Senior Fellow	Institute for Government	1
Patricia Miller · Chief Executive	NHS Dorset	1
Professor Jim McManus · Executive Director, Public Health	Hertfordshire County Council	1
Professor Sir Chris Ham · Co-Chair	NHS Assembly	1
Professor Vic Rayner OBE · Chief Executive	National Care Forum	1
Rob Darracott · Editor	P3 Pharmacy	1
Rob Webster · Chief Executive Lead	West Yorkshire Health and Care Partnership	1
Rt Hon Patricia Hewitt · Chair	NHS Norfolk & Waveney Integrated Care Board	1
Sarah McClinton · President	Association of Directors of Adult Social Services	1
Sarah Walter · Director, ICS Network	NHS Confederation	1
Sir David Nicholson · Chair	Sandwell and Birmingham NHS Trust and Dudley Group NHS Foundation Trust	1
Zina Etheridge · Chief Executive	North East London ICS	1

Correspondence

1 letter

Date	Direction	Title
6 Jun 2023	—	Correspondence from the Minister of State in the Department for Health and Soci…