Recommendation 25

HM Government Not Addressed

Whilst strategic, at-scale planning and commissioning is at integrated care system (ICS) level, the government recognises much of the activity to integrate care should be driven by collaboration between commissioners and providers over smaller geographic areas within integrated care systems (places). Place boundaries should be defined locally between key partners including local government and the NHS. The government will continue to work with place-based partnerships as they develop their collaborative arrangements including governance models. We have seen some good, albeit variable, progress in this area, and we will provide further support and advice to help places develop their approaches where needed. As far as possible, places should fall within ICS boundaries, but we recognise that in some areas this may be challenging. We have previously committed to reviewing the Cheshire and Merseyside ICS boundaries and the areas of North Yorkshire and Cumbria following the restructuring of local government in these areas. Partners may wish to review place arrangements to ensure that they meet local needs following any decisions related to these ICS boundary reviews. The government recognises the benefits of pooling resources to support the joint delivery of services. There are many good examples of local areas using mechanisms such as Government response 35 section 75 of the NHS Act 2006 to enable funding to be pooled to support the delivery of shared objectives, including through programmes such as the Better Care Fund. We have committed in the Integration White Paper to undertake a review of the section 75 regulations of the NHS Act 2006 with a view to simplifying them to support further use of pooled budget arrangements. The government has recently engaged with local partners, including from local government and the NHS, to better understand experiences of pooling and aligning budgets. We are also considering how we can best support places further and share good practice in this area. Conclusion 34 – housing needs within care provision Conclusion 34 - Integration strategies should seek to integrate not just health and care but health, care and housing. Ensuring there is holistic care that fits around a person’s needs includes preventing care needs from arising by having suitable housing, enabling people to live independently in their own homes, and ensuring that people receive the right care and support in the right setting, recognising that most people who receive care do so in their own home. Getting housing arrangements right for people is an essential part of the equation.