Recommendation 18

HM Government · verbatim extract Acknowledged

It continues to be the case that local leaders are best placed to make decisions about their local populations with fewer top-down national targets, missives and directives. That is why ICSs have greater devolved responsibilities than their predecessors. ICSs are accountable to the individuals and communities they serve. In addition, there are formal accountability arrangements for different partners of ICS that are defined in legislation and other supporting guidance, with local authorities held to account through local democratic processes and NHS organisations accountable to NHS England, which is in turn accountable to government and to Parliament. As mentioned in response to recommendations 3, 4 and 5, Oflog will enable us to look across the totality of adult social care and public health services delivery by local government to gain a holistic view of local government performance in these areas. This will help to improve performance, leading to better real-world outcomes for local people and the areas they live in. NHS England segments ICBs and NHS providers according to the level of support they require on a scale of 1 to 4 under the NHS oversight framework and this data is publicly available. CQC assessments of ICSs will provide independent assurance to the public and Parliament. DHSC and NHS England are committed to increased transparency of performance metrics and in November 2022, we started publishing practice-level appointment data for the first time, showing the length of time between when appointments are booked and when they take place. NHS England are also now publishing data on the number of people who had to wait over 12 hours from arrival at A&E, as set out in the delivery plan for recovery urgent and emergency care services. In this plan, we included a commitment to introduce a new discharge metric based on time from discharge-ready date to date of discharge and committed to start publishing data ahead of this winter; we also committed to develop and publish better data on the reasons for delayed discharges. DHSC are also working with the Department for Levelling Up, Housing and Communities ( DLUHC ), local government and Oflog to ensure that discharge metrics are included in the wider set of metrics that Oflog will use to assess local authority performance.