Source · Select Committees · Health and Social Care Committee
Seventh Report - Integrated Care Systems: autonomy and accountability
Health and Social Care Committee
HC 587
Published 30 March 2023
Recommendations
3
Acknowledged
Para 19
Integrated Care System targets should be outcome-based, with sparingly used delivery prescription.
Recommendation
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 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.
Department of Health and Social Care
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18
Acknowledged
Para 55
Set out how to empower MPs to hold local ICSs accountable with performance measures.
Recommendation
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 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.
Department of Health and Social Care
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Conclusions (5)
12
Conclusion
Acknowledged
Para 43
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 …
Government Response 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.
19
Conclusion
Acknowledged
Para 62
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 …
Government Response 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.
22
Conclusion
Acknowledged
Para 71
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 …
Government Response 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.
25
Conclusion
Acknowledged
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 …
Government Response 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.
26
Conclusion
Acknowledged
Para 82
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 Summary
The government acknowledges the opportunity to consider Healthwatch organisations' funding and commissioning arrangements given new expectations.