New ICS design framework offers clarity ahead of major reforms to health service but questions remain

16 June 2021

Responding to the publication of a new ICS design framework by NHS England and NHS Improvement, the deputy chief executive of NHS Providers, Saffron Cordery said:

"Today's ICS design framework sets out a much needed, clearer vision for how ICSs will develop further this year and how these new statutory bodies will operate when the health and care bill becomes law. We welcome the dialogue with NHS England and NHS Improvement throughout its development.

"The framework addresses many of the concerns outlined by our members, who fully support NHS England and NHS Improvement's ambition to set out a coherent, yet flexible operating model for ICSs from April 2022. Providers will particularly welcome recognition within the framework of their central, leadership role in ICSs and their commitment to delivering the best possible care for their local communities.

"But there are big challenges ahead as ICS leaders and their constituent organisations adjust to the complexities of system working.

"A key concern is that these NHS reforms- the most far reaching for nearly a decade- will take place against a challenging backdrop as trusts work to clear backlogs of care, restore routine services, and tackle pent up demand across urgent and emergency care, mental health and community health services.

"It is vital NHS England and NHS Improvement acknowledges the pressures and expectations trusts face as ICSs take a greater role in efforts to improve outcomes and support recovery while simultaneously embedding significant new planning and accountability arrangements.

"Trust leaders are keen to ensure ICSs remain a genuine partnership of all the organisations that contribute to local health and care services and outcomes within the system. They are increasingly concerned that the ICS model risks moving away from being a sum of its parts to a separate body managing those within it. There must be appropriate governance measures to ensure ICSs are accountable not only to NHS England and NHS Improvement and Parliament, but also to the communities they serve and the organisations within their footprint.

"In the coming weeks and months, we will continue to work closely with senior leaders and colleagues at NHS England and NHS Improvement as the framework is implemented and further guidance is produced. Alongside this, we will continue to regularly consult our members on key proposals to ensure their views are reflected as this framework progresses."

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