This week, a look at the new integrated care systems in the NHS and a few other developments in healthcare today.
What?
The NHS has changed in many ways since its inception in 1948, with the core aim of providing care that is free at the point of access being the constant thread through the decades.
However, things are changing across the NHS with the introduction of integrated care systems (ICSs). ICSs are a new innovation in England, designed to improve how the NHS works for you.
The healthcare needs of the UK have changed vastly from 1948. Life expectancy has increased, patients are more complex, and so too are their treatments – not to mention more expensive. While the NHS was always designed for the UK people, its structure was not designed to support the type of population we have today.
Different organisations work independently from one another and often do not communicate. This is why for example, if you attend an A&E in Newcastle, your GP in London will not know what treatment you have received. Even worse, the A&E doctor will not know your full history, if you cannot remember yourself (read more here about how to get better treatment in A&E). ICSs are designed to group geographical regions together to enable better working between organisations within the NHS. This will have the effect of joining up your care, and theoretically getting things done more quickly.
Why?
Integrated care systems are groupings of all NHS care organisations in 42 subregional areas (GPs, hospitals, mental health etc.) in England, all under the same organisation, making it easier to link up your care – whilst also making it easier to administer and pay for services at a governmental level. An ICS does not currently include local councils, which are often tasked with social care before or after discharge from hospital – something most may assume would be an NHS task.
The NHS does not communicate with the council, as you might have thought. But having one pot of money and one organisational structure often makes things work more smoothly. ICSs hope to bring about improved access to social care for elderly relatives, for example. How they will do this is unclear, as they do not include the council at present (although perhaps they will in years to come). However, hospitals may find it easier to shop around for services more easily in an ICS, which could lead to things like elective operations happening much more quickly.
Although ICSs have existed for some time, this year’s Health and Care Act gives them legal status, as well as new powers and responsibilities that allow them to deliver the benefits they promise. Integrated care systems are made up of two parts: integrated care boards and integrated care partnerships.
Another feature of ICSs is that, at a very local level, GP surgeries are coming together to form primary care networks (PCNs), and groups of practices working together across areas called ‘neighbourhoods’. Patient health and care organisations have also been working together across larger areas called ‘places’ – often covering the same area as a local authority – where large parts of the NHS budget are spent. The Health and Care Act 2022 aims to change this and make it easier for organisations to work together.
How (does it affect you?)
Your NHS is changing to improve the way your care is delivered. Understanding the way NHS systems interact is not necessary for a patient. However, understanding how it impacts you is important.
The ICSs will help, but not there’s still a long way to go. Major hospitals will maintain their influence, and will likely clash with ICS leadership, meaning that change cannot easily be realised. And the ICS won’t have the power to close underperforming organisations, or to make radical changes like relocating an A&E, even if such measures are required.
This means that the necessary money will not be freed up for the services the ICS wants to provide, and services also face other challenges, such as workforce shortages, growing waiting lists, and the lasting effects of the pandemic.
However, under the new system patient services should improve and things should happen more quickly. Care organisations should be joined up more effectively and care becomes more seamless. Discharges from hospital should be integrated into the community faster, and operations and procedures will theoretically happen more quickly. Patients can hop between GP surgeries for services such as vaccinations, and new systems are being implemented to provide out-of-hours appointments at neighbouring GP practices.
These changes are happening right now, so explore the options available at your local GP. The NHS faces an uncertain future, but ICSs are one of the ways that your health service will deliver more efficient care in the future.
Read more about ICSs here.
As always, best wishes from myHSN!
