The Health and Care Act 2022 contains the biggest reforms to the NHS in nearly a decade, with a key focus on improving health outcomes by joining up NHS, social care and wider services in statutory integrated care systems (ICSs). We have published an ICS FAQs document and jargon buster for governors, which aim to help you navigate the new system architecture. We have also published a guide summarising the Act for trusts, which aims to make the Act more readily accessible and help you find the areas most relevant to your roles. It sets out the key provisions in relation to trusts and systems and highlights forthcoming guidance and secondary legislation.  

The Act places ICSs on a statutory footing by establishing statutory integrated care boards (ICBs). The ICB will take on the commissioning functions of CCGs, as well as some of NHS England’s commissioning functions. The ICB board composition and governance model reflects the intention for greater integration and collaboration across the system, with at least one ‘partner member’ from the trusts, local authorities and primary care organisations in the system. Each ICB and relevant local authorities will be required to establish an integrated care partnership (ICP), bringing together wider partners across health, social care, public health, and representatives from other sectors that influence population health outcomes, such as social care providers or housing providers. The ICP will be tasked with developing an integrated care strategy. 

ICSs will need to be informed by the health needs and aspirations of their diverse populations. As set out in draft statutory guidance, trusts and ICBs will be expected to work in partnership with people and communities. ICBs have a duty to reduce inequalities in access and outcomes, and to have regard to the ‘triple aim’ which is now a statutory requirement. ICBs also have legal duties relating to public involvement, and must produce annual reports to show how these duties have been met. For trust boards, the focus should be on contributing to the objectives of the ICS, and as governors you’ll want to add this to the range of things you ask your board for assurance about. Governors may also wish to ask non-executive directors how assured they are that the trust is contributing to involving and engaging with local communities from an organisational and a system perspective.