Integrated Care Systems (ICSs) - The Difficult Road Ahead

We have all been there. Repeating ourselves for what feels like the 100th time about why we are seeking medical help.

42 Integrated Care Systems (ICSs) have been created across the country to resolve the disconnect between health services by bringing together professionals from various organisations to offer the best service to patients.

An infographic about the terminology surrounding ICSs

Faster, digitised and shared communication. Sounds great, right? It’s not as easy as it sounds, though.

Integrated Care Systems (ICSs) are under immense pressure to deliver over the next three years. ICSs are expected to ensure:

Digitising Services

·??????a core level of digitisation across all NHS secondary care providers

·??????90 per cent of NHS trusts to have an electronic patient record (EPR) system by December 2023, 100 per cent by March 2025

·??????80 per cent of adult social care services to have electronic records by March 2024

·??????ability to deliver uninterrupted provision of patient care even in the face of a cyber incident

·??????every patient to have the right to be offered digital-first primary care by 2023/24.?

Connected systems:

·??????every ICS has a fully functional integrated health and social care record that can be used fully by all constituent parts of the ICS.

Transformation:

·??????services are transformed to provide access to digitalised care and promote digital inclusion

·??????the workforce is fully trained, confident and proficient in using digital technologies

·??????75 per cent of adults registered for the NHS App by March 2024

·??????innovation is enabled and embedded into the NHS health and social care system. (NHSCONFED, 2022 )

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However, recent research by the HSJ has found that not all ICS are equal and to hold all ICSs accountable to the same policies isn’t attainable for all ICSs .

For starters, ICSs come in a range of sizes with different responsibilities. Then, they need to face challenges such as:

·????10% of vacancies being un-filled in the NHS

·????A backlog of over 6.48 million people waiting for treatment

·????Inequalities that affect certain regions more than others

We spoke to Paul Charnley, former CIO and now Digital Lead for Healthy Wirral Partners about the complexities surrounding ICSs.

Charnley says, ‘‘I think the challenge is about old infrastructure, lack of investment and all the change and pressure the NHS is under. But these have always been the issue, and some places have been better at making progress despite this.’

In a research paper from the NHS Confederation , an NHS ICS Digital Leader echoes Charnley’s thoughts and explains ‘“It is a very challenging time when we are being asked to balance the need to accelerate focus on the recovery of services, still living with COVID-19, and the ask of frontline staff to be involved in progressing digital implementation and change.”?

The solution is not simple, but there are steps to tackle the issues. Charnley explains, ‘In my humble opinion, the answer is a shared vision and a clear joint strategy within the digital community in the ICS but more crucially also shared with the clinical and operational communities.’

Health Tech found working together is a 'recurring' theme in their survey involving healthcare professionals about what they think success in ICSs looks like. They also mentioned the need for Electronic Patient Records (EPR) .

St. Vincent’s Consulting is currently working on doing just that. Working on an ecosystem that combines a variety of partnerships to form one big powerhouse of services enables Trusts to benefit from multiple services at once that liaise with each other.

Charnley advises organisations to identify and solve issues at the core to improve their current healthcare challenges and then acquire more funding to meet ICS goals. This way, healthcare organisations can be better equipped to solve further challenges whilst achieving ICS goals.

Furthermore, he stresses once there is a joint and united strategy, this then ‘needs to be followed up by continuity and strength in the bonds between organisations’ through open communication, less competition, and a mission to share what is known.

St. Vincent’s always considers the voices of NHS advisors in senior roles to improve our NHS. Upon our conversations with them, our CEO and COO have recognised a real need for a digital solutions hub where Trusts can share, collaborate, access solutions and learn from each other in an easily accessible Teams structure.

Charnley finishes with some words of wisdom – ‘If you get all the said above right, you might still only be able to see problems ahead of you, but you can see significant progress behind you.’

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