The plan offers a positive vision of what the NHS could look like in the future and, in doing so, addresses a number of existing problems within the current system. NHS Providers welcomes this direction of travel, but acknowledges that a vast amount of work is needed before the benefits of such a vision will be consistently realised.
In our view, ICSs play a helpful role as a forum for local partners to agree shared vision and priorities, and to discuss how to make best use of their collective resource for patient benefit. However, the role of an ICS should not automatically become the default mechanism to deliver national policy initiatives.
The April 2021 deadline is ambitious for providers to transition to ICS status, especially in challenged areas where functional and collegiate relationships do not exist and are perhaps hampered by a culture of competition or long-standing historic differences. NHS England/Improvement have outlined their plans to create a development offer to support systems to undertake the required organisational development to deliver the plan, which we welcome. It is vital this is developed collaboratively between national and local leaders.
In our view, ICSs play a helpful role as a forum for local partners to agree shared vision and priorities, and to discuss how to make best use of their collective resource for patient benefit. However, the role of an ICS should not automatically become the default mechanism to deliver national policy initiatives.
The question of governance and a lack of statutory framework that would underpin the vision outlined in the long term plan remains unanswered. The proposed legislative changes go some way to support more effective, rapid and consistent integration, but there is a danger they reduce local autonomy, and cut across the central principle and importance of accountability of unitary trust boards.
For the aspirations outlined in the long term plan to be realised, it is essential that providers, and their partners are fully engaged in co creating emerging guidance and frameworks – and that the upcoming implementation guidance address some of these questions, providing a supportive atmosphere for providers to progress this work and supporting a constructive central/local partnership between the frontline and the national bodies. NHS Providers looks forward to working with NHS England/Improvement colleagues to support this approach.