Recommendations & Conclusions
10 items
8
Conclusion
Seventh Report - Integrated Care System…
Deferred
NHS England should provide an update on whether they intend to refresh their 2019 Long-Term Plan and, if so, when. Any update to NHS England’s Long-Term Plan must put prevention and long-term transformation at its heart, empowering ICSs to pursue these priorities and giving them the confidence that they have …
Government response. The government deflected from updating the Long-Term Plan, instead focusing on leadership development and stating that a senior advisory group has been brought together to plan a 3-year roadmap for leadership support.
Department of Health and Social Care
10
Conclusion
Seventh Report - Integrated Care System…
Deferred
To guarantee a continual focus on the prevention agenda, all Integrated Care Boards should ensure they include a public health representative, such as a public health director or public health lead. In 12 months, DHSC should conduct a review to understand the extent to which this is happening. If necessary, …
Government response. The government deflected from mandating public health representation on ICBs by suggesting that a national peer review offer should be developed by partners within the system.
Department of Health and Social Care
14
Conclusion
Seventh Report - Integrated Care System…
Deferred
The Government and NHS England should set up and fund an ICS leadership development programme, specifically targeted at supporting leaders of and within ICSs to develop the skills required to be successful system leaders (Paragraph 48) Accountability
Government response. The government deflected from setting up and funding an ICS leadership development programme, instead discussing local accountability, the role of Oflog, and new performance metrics for various health services.
Department of Health and Social Care
15
Conclusion
Seventh Report - Integrated Care System…
Deferred
We share the concern expressed by the NAO about the lack of clarity around what ICSs are expected to deliver within their core purposes. While we are conscious of, and agree with, the need to avoid micromanaging ICSs, we believe that DHSC needs to provide additional clarity about what exactly …
Government response. The government deflected from providing clarity on what ICSs are expected to deliver, instead discussing the public availability of ICB board member information and their discretion in appointing additional members.
Department of Health and Social Care
16
Conclusion
Seventh Report - Integrated Care System…
Deferred
Following engagement with ICSs and being conscious of the space required for local priorities, DHSC and NHS England should issue guidance with additional detail on what ICSs are expected to achieve within each of the four core purposes. As we have said previously, the focus here should be on outcomes …
Government response. The government deflected from issuing guidance on what ICSs are expected to achieve within their core purposes, stating that ICB partnership arrangements are discussed in annual assessments and CQC will assess wider ICS partnership working.
Department of Health and Social Care
20
Conclusion
Seventh Report - Integrated Care System…
Deferred
NHS England should provide more clarity about what ICSs should expect in terms of the monitoring of partnership working and how this will be assessed in ICB annual assessments.
Government response. The government's response discussed the development of a new very senior manager (VSM) pay framework to improve consistency and transparency, which is unrelated to the recommendation about monitoring partnership working in ICSs.
Department of Health and Social Care
27
Conclusion
Seventh Report - Integrated Care System…
Deferred
DHSC should therefore review the funding and commissioning arrangements for Healthwatch, with a view to ensuring they are fit for purpose within the context of new ICSs, and support Healthwatch to have a clear voice. The outcome of this review should be reported to the House.
Government response. The government response detailed the importance of the prevention agenda, the role of directors of public health, and ICB duties regarding public health, but did not address the recommendation concerning a review of Healthwatch funding and commissioning arrangements.
Department of Health and Social Care
28
Conclusion
Seventh Report - Integrated Care System…
Deferred
Given that the CQC will have the legal powers to conduct assessments from April 2023, it is concerning that there are still outstanding questions that the Government needs to provide clarity on. This is particularly around any priorities DHSC may have for the assessments, and whether the CQC will be …
Government response. The government's response focused on the importance of the prevention agenda and developing methodologies for defining and baselining preventative healthcare spending, completely sidestepping the committee's concern about providing clarity to the CQC on assessment priorities and ratings.
Department of Health and Social Care
29
Conclusion
Seventh Report - Integrated Care System…
Deferred
DHSC should urgently provide the CQC with its decision on ratings and any priorities it would like the CQC to focus on. It should also communicate to ICSs what methods will be used to address any areas of concern that assessments might raise. ICSs should be given fair notice about …
Government response. The government response focused on the UK-wide Levelling Up health mission, establishing a cross-government Health Mission Working Group, and the upcoming publication of a toolkit for local shared outcomes frameworks, without providing the requested clarity on CQC ratings or assessment …
Department of Health and Social Care
30
Recommendation
Seventh Report - Integrated Care System…
Deferred
DHSC and NHS England should review existing regulatory assessments for ICSs with a view to ensuring there is as little duplication as possible. We recommend this work is done alongside the Department for Levelling Up, Housing and Communities given their role in local authority assurance. (Paragraph 94) 28 Integrated Care …
Government response. The government response highlighted existing forums and networks available to ICSs for facilitating learning and sharing best practice, but did not commit to reviewing existing regulatory assessments for duplication as recommended.
Department of Health and Social Care