Seventh Report - Integrated Care Systems: autonomy and accountability
Select Committee
Health and Social Care Committee
HC 587
30 March 2023
Government response
Government Response to the Committee's Seventh Report of Session 2022-23 on Integrated Care Systems: autonomy and accountability · published 14 Jun 2023
Recommendations & Conclusions
10 results
8
Conclusion
Deferred
NHS England Long-Term Plan requires update to prioritise prevention and long-term transformation.
Conclusion
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 …
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Government Response Summary
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
Para 39
Integrated Care Boards need public health representation; DHSC review required for mandating inclusion.
Conclusion
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 …
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Government Response Summary
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
Establishing a dedicated ICS leadership development programme is crucial for successful system leaders.
Conclusion
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 Summary
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
Para 52
Lack of clarity on ICS deliverables hinders public and parliamentary accountability.
Conclusion
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 …
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Government Response Summary
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
Para 53
Clear guidance detailing ICS outcomes for core purposes is required from DHSC/NHS England.
Conclusion
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 …
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Government Response Summary
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
Para 63
Need for NHS England to clarify monitoring of partnership working in ICSs
Conclusion
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 Summary
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
Para 83
Urgent need for DHSC to review Healthwatch funding and commissioning arrangements
Conclusion
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 …
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Government Response Summary
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
Para 92
Outstanding clarity issues concern CQC's readiness for system assessments from April 2023
Conclusion
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 …
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Government Response Summary
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
Para 93
DHSC needs to urgently clarify CQC assessment decisions and priorities for ICSs
Conclusion
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 …
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Government Response Summary
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
Review existing regulatory assessments for ICSs to minimise duplication with DLUHC
Recommendation
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 …
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Government Response Summary
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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