Source · Select Committees · Health and Social Care Committee
Recommendation 4
4
Accepted
Paragraph: 27
Local Integrated Care System priorities risk being overshadowed by national directives.
Conclusion
We welcome the clear references to local priorities within NHS England guidance for ICSs and DHSC’s proposed shared outcomes framework. We hope that, in the years to come, this focus on local priorities will be maintained. However, we share the NAO’s concern about the tension between local needs-based strategies and a national standardised service. Experience shows that locally determined priorities may become the poorer relation to priorities driven nationally.
Government Response Summary
The government explained its existing framework for balancing national and local priorities through the Health and Care Act 2022 and recent planning guidance, and committed to publishing a shared outcomes toolkit to support the development of local outcomes.
Paragraph Reference:
27
Government Response
Accepted
HM Government
Accepted
An effective health and care system is able to respond to both national and local priorities for improving services and outcomes; and progress in delivering those priorities will need to be measured and accounted for. The framework created by the Health and Care Act 2022 provides for the Secretary of State to set national priorities for the NHS through the mandate to NHS England. NHS England uses its planning guidance to translate mandate requirements into operational requirements for the NHS. The recently published plans for primary care, elective backlogs and urgent and emergency care set out key current national priorities for NHS recovery. ICSs bring together NHS bodies, local authorities and their partners to agree how the universal commitments to the public are best met in their areas, alongside any specific priorities for improving services and outcomes for their communities. ICSs should be enabled to set a focused number of locally co-developed priorities and we have already taken meaningful steps towards this approach, for example, recent reforms to the Commissioning for Quality and Innovation (CQUIN) 2023 to 2024 guidance pivoted from wholly national targets to identifying a small number of clinical priority areas, allowing local areas to also prioritise locally co-developed priorities and targets. Whole system planning is captured in the integrated care strategies developed by ICPs and the joint forward plans prepared by ICBs , and the plans of local authorities in the ICS area. These will be informed by joint strategic needs assessments and the joint local health and well-being strategies that describe the health needs across each ICS and the local priorities for addressing. These plans will support the delivery of the 4 purposes of ICSs as set out by NHS England: improve outcomes in population health and healthcare tackle inequalities in outcomes experience and access enhance productivity and value for money help the NHS support broader social and economic development DHSC are also committed to publishing a shared outcomes toolkit to support the development of local outcomes.