Female doctor in a team meeting

ICS review to give health leaders more autonomy and accountability

During his autumn statement and alongside a whole host of other things, Chancellor Jeremy Hunt announced that he had asked Patricia Hewitt to oversee an independent review into how ICSs can best succeed.

In short, the review will look to identify the most efficient and effective ways of harnessing the true potential of the ICS – whether that be making local leaders more accountable for things like performance and expenditure via a devolution of power across the board or simply reducing the number of national targets to allow local leaders the bandwidth to make the right choices for their areas.

Like Hunt, Hewitt is a former health secretary after serving between May 2005 and June 2007 under Tony Blair’s premiership. Now though, she is the Chair of Norfolk and Waveney’s ICB.

Responding to the news, she said: “I am delighted to have been asked to lead this review of how integrated care systems can best be empowered and supported to succeed.

“By bringing together local government, the NHS and the voluntary, community and social enterprise sector, ICSs provide the biggest opportunity in a generation to improve health outcomes, transform health and care services and reduce health inequalities.

“Despite the many challenges we face, I am excited by how much has already been achieved in many different systems, including in Norfolk and Waveney, and optimistic about what our partnerships can do in future as we respond to the different needs of our own communities.

“This review will focus on how national policy and regulation can most effectively support and enable local systems to solve problems locally. It will build on the welcome work already done by NHS England to develop a new operating model.

“I look forward to working with colleagues from all 42 ICSs as well as the Department of Health and Social Care, NHS England, colleagues in local government and others as we respond to the Health Secretary’s and the Chancellor’s invitation to help create a system of regulation and accountability based on the principle that change should be locally led and nationally enabled.”

The DHSC say the review will consider four things:

  1. Whether a smaller number of national targets will give local health leaders greater autonomy, allowing them to focus more on local challenges, as mentioned above
  2. Whether local performance can be better monitored, with nods to the possibility of local targets and a greater focus on transparency
  3. How to ensure ICSs are held to account – locally and nationally
  4. The general relationship between ICSs and organisations like NHS England and the Care Quality Commission (CQC), as well looking into the CQC’s role as an ICS overseer

NHS England Chair, Richard Meddings, added: “As a health service we are focused on delivering the best possible care for all our patients, as well as value for taxpayers.

“With both the economy and the NHS facing tough challenges ahead, it’s absolutely right that we continue to find more innovative ways to ensure all our systems are working as efficiently as possible. We also need to continue to provide the tools to help local systems solve the problems they face on the ground – building on the operating model we have already set out.

“That’s why we welcome this week’s announcement of a new independent review and will work closely with its chair, the Rt Hon Patricia Hewitt, to help the NHS to continue to deliver for patients, as well as the public purse.”

Before the year’s out, an interim report will be published with the full review expected sometime next year.

The full review will include the expertise and insight of everyone from ICS leaders and NHS England to academia and patient representatives.

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NHE May/June 2024

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