NHS Providers responds to the Hewitt Review

04 April 2023

Responding to the Rt Hon Patricia Hewitt's review of oversight and governance of integrated care systems (ICSs), Sir Julian Hartley, chief executive at NHS Providers said:

"At a time of great pressure across the health and care system, ensuring the right oversight, accountability and support for trusts and ICSs is critical.

"We welcome this report as it highlights how ICSs can help integrate care, forge partnerships within and beyond the NHS, and shift towards a preventative model of care.

"The emphasis on improvement over top-down performance management is essential and we hope the NHS at all levels will commit to the cultural shift necessary to bring this about."

Further positive elements of the review include:

However, Sir Julian also expressed some concerns:

"The review needs more clarity on the responsibilities and accountabilities of different system players.

"We worry that trusts and integrated care boards (ICBs) will struggle to work as equal partners while ICBs have day-to-day oversight of providers.

"We're also concerned that some recommendations could add complexity and bureaucracy – for example, with auditing prevention spending and reframing the role of local government oversight.

"Likewise, while we support equal focus on waits for elective care and acute mental health treatment, we're concerned that significant backlogs of care in the community sector are not highlighted.

"We thank Patricia Hewitt for the extensive engagement she undertook in producing this review, and for listening to trusts' concerns and aspirations throughout. We look forward to continuing to work to support this review's implementation."