Leadership in integrated care systems (ICSs)

Social Care Institute for Excellence | November 2018 | Leadership in integrated care systems (ICSs)

The NHS Leadership Academy commissioned SCIE (Social Care Institute for Excellence) to undertake  research to further expand the understanding of systems leadership and leadership of integrated care systems. The research will inform the Leadership Academy’s long-term plans for supporting leaders in integrated care systems.

This Future of Care paper, aimed at chief executives, directors and senior managers from the NHS, local authorities, housing organisations and voluntary and community sector, is based on findings from interviews with systems leaders and a review of the literature (Source: SCIE).


Report available from  SCIE

See also: Free online webinar 

Ways of integrating care that better coordinate services may benefit patients

NIHR | December 2018 | Ways of integrating care that better coordinate services may benefit patients

In one of its latest Signals, the NIHR highlights a systematic review identified 267 pieces of literature from the UK and countries with a comparable economy, all published from 2006onwards, which analysed and described new models of integrated care. 

The review- funded by the NIHR-  looked at the international literature to understand how new care models may affect patients, providers and systems. Almost half of the 267 studies came from the UK. Most investigated integrated care pathways, often as part of a multicomponent intervention including multidisciplinary teams and some form of case management. Most studies focused on older people.



The review finds some positives, but overall highlights the complexity of implementing and assessing new models of care. The reviewers found the complexity and variability of interventions across the literature, a hindrance in understanding the effect of specific changes. Most studies were at risk of bias, with few comparison studies as these are often not appropriate for organisational research (Source: NIHR).

Read the NIHR Signal in full here 

Published abstract here



Round two for STP plans: a fresh start or a dangerous distraction?

The King’s Fund | November 2018 | Round two for STP plans: a fresh start or a dangerous distraction?

Anna Charles, writing on The King’s Fund blog, discusses a recent letter
to Trust  chief executives and clinical commissioning group (CCG) accountable officers, NHS England and NHS Improvement confirmed that they ‘expect all sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) to develop and agree new strategic plans for improving quality, achieving sustainable [financial] balance and delivering the long-term plan.’  Charles writes that these will be developed during the first six months of 2019 and submitted for sign-off later that year. At the same time, one- year organisational plans will be submitted for 2019/20 (Source: The King’s Fund). 

Read the long read in full from The King’s Fund blog 

How should health policy respond to the growing challenge of multimorbidity?

Experts call for health system change to tackle the challenge of multimorbidity in the NHS. The report discusses the need for patient-centred care, with more emphasis on generalist rather than specialist care and better integration between general practice, hospitals and social care| University of Bristol

Image source: http://www.bristol.ac.uk

People with multimorbidity – one or more long-term health conditions, such as diabetes, heart disease and dementia – are more likely to experience poor quality of life and poor physical and mental health. They use both general practice and hospital services far more often than the general population. However, healthcare systems around the world are largely designed to manage individual diseases or episodes of illness rather than patients with complex multiple health care needs.


This policy report makes a series of policy recommendations including:

  • Promoting patient-centred approaches to the management of multimorbidity in primary care, which requires training, support and changes in incentives.
  • Developing and evaluating new approaches to managing patients with multimorbidity within hospitals.
  • Exploring new models of integration of primary and community care, hospital care and social care which enable better co-ordination and support for people with multimorbidity, which is likely to require substantial changes in commissioning and funding mechanisms, and a rebalancing of resources.
  • Changes to professional education, training and regulation to prepare professionals to manage patients with multimorbidity in new and more integrated systems.
  • Engaging and enabling people to manage their own health and long-term conditions, requiring co-ordinated action across many aspects of government and public life.
  • More research to understand and improve care for multimorbidity.

Full report: How should health policy respond to the growing challenge of multimorbidity? | University of Bristol

Health and care integration

Interface between health and social care | Public Accounts Committee

This report highlights the widespread consensus that integration and joint working is the right way forward for the health and social care system to deliver the best and most effective outcomes for people and their families.

Financial pressures and an ageing population have both increased the need for joined-up working, with local authorities reducing real-terms spending on adult social care by 5.3% between 2010-11 and 2016-17, while the number of people in England aged 85 and over rose by 28% between 2006 and 2016.

However, the report finds that the government lacks an effective overall strategy or plan to achieve its aim of integrating the health and social care sectors. It recommends the government should set out a costed 10-year plan for social care to go with its 10-year plan for the NHS.

Directions for integrated care providers (ICPs)

Department of Health and Social Care | October 2018 | Directions for integrated care providers (ICPs)

The Department of Health and Social Care have launched a  consultation aimed at GPs and others involved in the provision of primary medical services. It set outs the draft directions for those providing primary care as part of an ICP and asks if the draft provisions for a new ICP contract are effective and sufficient, and whether there are any other impacts the government should be aware of.

Separately, NHS England is consulting on the new ICP contract between 3 August and 26 October 2018. This would make a single organisation contractually responsible for delivering integrated care services and improved health outcomes for the population of an area (Source: Department of Health and Social Care).

Full details here 

Healthy places: the link between your health and where you live [podcast]

The King’s Fund | September 2018 | Healthy places: the link between your health and where you live

The latest podcast from The King’s Fund considers the link between your health and where you live. It questionsHow do we make places healthier? Helen McKenna talks with Kate Ardern, Director of Public Health at Wigan Council, André Pinto, Public Health Manager from Public Health England and Chris Naylor, Senior Fellow from The King’s Fund.


Listen to it on Apple, Stitcher, Spotify and Acast or at The King’s Fund website