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
10 results
Clear
8 Conclusion Deferred
Seventh Report - Integrated Care S…
NHS England Long-Term Plan requires update to prioritise prevention and long-term transformation.
NHS England should provide an update on whether they intend to refresh their 2019 Long-Term Plan and, if so, when. Any update to NHS England’s Long-Term Plan must put prevention and long-term transformation at its heart, empowering ICSs to pursue … Read more
Government Response
The government deflected from updating the Long-Term Plan, instead focusing on leadership development and stating that a senior advisory group has been brought together to plan a 3-year roadmap for leadership support.
Department of Health and Social Care
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10 Conclusion Deferred
Seventh Report - Integrated Care S…
Integrated Care Boards need public health representation; DHSC review required for mandating inclusion.
To guarantee a continual focus on the prevention agenda, all Integrated Care Boards should ensure they include a public health representative, such as a public health director or public health lead. In 12 months, DHSC should conduct a review to … Read more
Government Response
The government deflected from mandating public health representation on ICBs by suggesting that a national peer review offer should be developed by partners within the system.
Department of Health and Social Care
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14 Conclusion Deferred
Seventh Report - Integrated Care S…
Establishing a dedicated ICS leadership development programme is crucial for successful system leaders.
The Government and NHS England should set up and fund an ICS leadership development programme, specifically targeted at supporting leaders of and within ICSs to develop the skills required to be successful system leaders (Paragraph 48) Accountability
Government Response
The government deflected from setting up and funding an ICS leadership development programme, instead discussing local accountability, the role of Oflog, and new performance metrics for various health services.
Department of Health and Social Care
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15 Conclusion Deferred
Seventh Report - Integrated Care S…
Lack of clarity on ICS deliverables hinders public and parliamentary accountability.
We share the concern expressed by the NAO about the lack of clarity around what ICSs are expected to deliver within their core purposes. While we are conscious of, and agree with, the need to avoid micromanaging ICSs, we believe … Read more
Government Response
The government deflected from providing clarity on what ICSs are expected to deliver, instead discussing the public availability of ICB board member information and their discretion in appointing additional members.
Department of Health and Social Care
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16 Conclusion Deferred
Seventh Report - Integrated Care S…
Clear guidance detailing ICS outcomes for core purposes is required from DHSC/NHS England.
Following engagement with ICSs and being conscious of the space required for local priorities, DHSC and NHS England should issue guidance with additional detail on what ICSs are expected to achieve within each of the four core purposes. As we … Read more
Government Response
The government deflected from issuing guidance on what ICSs are expected to achieve within their core purposes, stating that ICB partnership arrangements are discussed in annual assessments and CQC will assess wider ICS partnership working.
Department of Health and Social Care
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20 Conclusion Deferred
Seventh Report - Integrated Care S…
Need for NHS England to clarify monitoring of partnership working in ICSs
NHS England should provide more clarity about what ICSs should expect in terms of the monitoring of partnership working and how this will be assessed in ICB annual assessments.
Government Response
The government's response discussed the development of a new very senior manager (VSM) pay framework to improve consistency and transparency, which is unrelated to the recommendation about monitoring partnership working in ICSs.
Department of Health and Social Care
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27 Conclusion Deferred
Seventh Report - Integrated Care S…
Urgent need for DHSC to review Healthwatch funding and commissioning arrangements
DHSC should therefore review the funding and commissioning arrangements for Healthwatch, with a view to ensuring they are fit for purpose within the context of new ICSs, and support Healthwatch to have a clear voice. The outcome of this review … Read more
Government Response
The government response detailed the importance of the prevention agenda, the role of directors of public health, and ICB duties regarding public health, but did not address the recommendation concerning a review of Healthwatch funding and commissioning arrangements.
Department of Health and Social Care
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28 Conclusion Deferred
Seventh Report - Integrated Care S…
Outstanding clarity issues concern CQC's readiness for system assessments from April 2023
Given that the CQC will have the legal powers to conduct assessments from April 2023, it is concerning that there are still outstanding questions that the Government needs to provide clarity on. This is particularly around any priorities DHSC may … Read more
Government Response
The government's response focused on the importance of the prevention agenda and developing methodologies for defining and baselining preventative healthcare spending, completely sidestepping the committee's concern about providing clarity to the CQC on assessment priorities and ratings.
Department of Health and Social Care
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29 Conclusion Deferred
Seventh Report - Integrated Care S…
DHSC needs to urgently clarify CQC assessment decisions and priorities for ICSs
DHSC should urgently provide the CQC with its decision on ratings and any priorities it would like the CQC to focus on. It should also communicate to ICSs what methods will be used to address any areas of concern that … Read more
Government Response
The government response focused on the UK-wide Levelling Up health mission, establishing a cross-government Health Mission Working Group, and the upcoming publication of a toolkit for local shared outcomes frameworks, without providing the requested clarity on CQC ratings or assessment priorities for ICSs.
Department of Health and Social Care
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30 Recommendation Deferred
Seventh Report - Integrated Care S…
Review existing regulatory assessments for ICSs to minimise duplication with DLUHC
DHSC and NHS England should review existing regulatory assessments for ICSs with a view to ensuring there is as little duplication as possible. We recommend this work is done alongside the Department for Levelling Up, Housing and Communities given their … Read more
Government Response
The government response highlighted existing forums and networks available to ICSs for facilitating learning and sharing best practice, but did not commit to reviewing existing regulatory assessments for duplication as recommended.
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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