How do we redraw the circles so that ‘Connecting people’ is at the centre of Integrated Care Systems?

Last week NHS England published Neighbourhood Health Guidelines for 2025/26, intended to guide the work of each Integrated Care System until the revised 10 Year Plan is published. Upfront and centre in the guidelines is a diagram consisting of 3 circles, with the innermost circle being 2025/26’s primary focus of preventing people from ‘spending unnecessary time in hospital and care homes’.

The guidelines go on to say ‘As core relationships between the local partners grow stronger, we expect systems to focus increasingly on the outer circles’ – the outermost circle being ‘Connecting people accessing health and care to wider public services and third sector support, including social care, public health and other local government services’.

Now one problem I have with this is the suggestions that this is all new and that attempts to change the way healthcare is organised and delivered haven’t been going on for at least 10 years. NHS England itself traces the history of Integrated Care Systems to the NHS Five Year Forward View published in 2014. So my question is why do we still not have a shared understanding that ‘connecting people accessing health and care to wider public services and third sector support’ is absolutely without doubt (in my mind at least) one of the most effective ways to ‘prevent people from spending unnecessary time in hospital and care homes’? A year ago Locality published Keep it Local for Better Health and I am sure there are many reports from the The King's Fund Power to Change Joseph Rowntree Foundation (JRF) and others that demonstrate this.

What have we, as VCFSE organisations failed to do to convince the decision makers that this is the case? What do we need to do now to help the people who lead ‘the system’ to recognise the large contribution that VCFSE organisations could make if only ‘the system’ started with the view that accessing NHS services is the end point of an individual’s health journey and not the first port of call? How can VCFSE organisations come together to demonstrate the power of ‘treating’ the person as a whole, as a family member and as part of a community rather than as an illness or condition to be cured? How do we, as both people and organisations, step up and say ‘without us there is no Integrated Care System’?

So I am sat this week wondering how we, VCFSE organisation around the country, come together to help the government see that we are not an adjunct to an integrated health and social care system, we are in fact the core of making sure that people live well and age well. How do we tell the story better that civil society in its widest form helps individuals and communities thrive - associative activity helps to keep us well, having purpose helps to keep us well, being active helps to keep us well, and these are the things (amongst many, many, more things) that VCFSE organisations support people and communities to do.

How can we change the thinking and help drive the move from a model of health and social care that focuses on treating the sick (and people passively receiving care) to one that keeps us well and encourages people to actively participate in keeping themselves well and to do this at a neighbourhood level?

How do we, as individuals, move away from being consumers of health and social care services towards becoming co-creators of our own well-being? ?

How do we redraw the circles so that ‘Connecting people’ is at the centre of Integrated Care Systems?