Integrated Care Systems: autonomy and accountability

Health and Social Care Committee Closed Inquiry
Opened: 6 Jul 2022 Closed: 15 Aug 2023 Parliament page
The Health and Social Care Committee has launched a new inquiry to consider how Integrated Care Systems will deliver joined up health and care services to meet the needs of local populations. Forty-two new ICSs were established with a statutory footing across England on 1 July. Integrated Care Boards, one … Read more
10 Recommendations
20 Conclusions
1 Report
4 Oral sessions
1 Letter
4 Events
Activity timeline 11 events
14 Jun
2023
Report published
6 Jun
2023
Correspondence
30 Mar
2023
Report published
7 Feb
2023
Oral evidence
7 Feb
2023
Formal meeting (oral evidence session) · Room 16, Palace of Westminster
17 Jan
2023
Oral evidence
17 Jan
2023
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
6 Dec
2022
Oral evidence
6 Dec
2022
Formal meeting (oral evidence session) · The Thatcher Room, Portcullis House
8 Nov
2022
Oral evidence
8 Nov
2022
Formal meeting (oral evidence session) · Room 16, Palace of Westminster
Oral evidence sessions 4 sessions
7 Feb 2023
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Helen Whatley MP · Department of Health and Social Care Mark Cubbon · NHS England Matthew Style · Department of Health and Social Care
17 Jan 2023
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Kate Terroni · Care Quality Commission Louise Ansari · HealthWatch Nicholas Timmins · Institute for Government Sarah Walter · NHS Confederation Zina Etheridge · North East London ICS
6 Dec 2022
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Andrew Lane · National Pharmacy Association Dr David Wrigley · British Medical Association GP Committee Dr Linda Patterson · Bradford District Care NHS Foundation Trust Dr Trudi Seneviratne OBE · Royal College of Psychiatrists Miriam Deakin · NHS Providers Professor Jim McManus · Hertfordshire County Council Professor Vic Rayner OBE · National Care Forum Rob Darracott · P3 Pharmacy Sarah McClinton · Association of Directors of Adult Social Services
8 Nov 2022
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Chris Hopson · NHS England Councillor David Fothergill · Local Government Association Patricia Miller · NHS Dorset Professor Sir Chris Ham · NHS Assembly Rob Webster · West Yorkshire Health and Care Partnership Rt Hon Patricia Hewitt · NHS Norfolk & Waveney Integrated Care Board Sir David Nicholson · Sandwell and Birmingham NHS Trust and Dudley Group NHS Foundation Trust
Title HC No. Published Items Response
Seventh Report - Integrated Care Systems: autonomy and accountab… HC 587 30 Mar 2023 30 Responded
Recommendations & Conclusions
7 results
Clear
3 Recommendation Acknowledged
Seventh Report - Integrated Care S…
Integrated Care System targets should be outcome-based, with sparingly used delivery prescription.
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
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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12 Conclusion Acknowledged
Seventh Report - Integrated Care S…
DHSC requires urgent clarity on providing advance funding information to Integrated Care Systems.
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 … Read more
Government Response
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.
Department of Health and Social Care
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18 Recommendation Acknowledged
Seventh Report - Integrated Care S…
Set out how to empower MPs to hold local ICSs accountable with performance measures.
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
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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19 Conclusion Acknowledged
Seventh Report - Integrated Care S…
Unclear monitoring and accountability mechanisms for partnership working in ICSs
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 … Read more
Government Response
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.
Department of Health and Social Care
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22 Conclusion Acknowledged
Seventh Report - Integrated Care S…
Unclear how government will monitor professional representation on Integrated Care Boards
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 … Read more
Government Response
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.
Department of Health and Social Care
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25 Conclusion Acknowledged
Seventh Report - Integrated Care S…
Good patient and carer involvement essential for ICS to meet local needs
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 … Read more
Government Response
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.
Department of Health and Social Care
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26 Conclusion Acknowledged
Seventh Report - Integrated Care S…
Opportunity to review Healthwatch funding and commissioning arrangements given new expectations
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
The government acknowledges the opportunity to consider Healthwatch organisations' funding and commissioning arrangements given new expectations.
Department of Health and Social Care
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Government Response AI assessment · 30 of 10 classified
Accepted 12
Acknowledged 7
Deferred 10
Not Addressed 1
Total 10 recs + 20 conclusions
Correspondence 1 letter
6 Jun 2023 Correspondence from the Minister of State in the Department for Health and Social Care on the ICS response date
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