Key points within our submission include: 

• Integrated care systems (ICSs) are being created at a challenging time for the health and care system, with a constrained financial envelope, insufficient access to capital, workforce shortages, and unprecedented levels of operational pressure. Creating space for ICS leaders, and their partners, to drive forward their strategic objectives as well as supporting providers, places and provider collaboratives, to rise to operational challenges, remains important.
• Despite a challenging operational context, trust leaders see significant opportunity for provider collaboratives to take on additional responsibility and to help reduce unwarranted variation in quality, improve efficiency and tackle care backlogs within a new system context. Many trust leaders are also committed to integrating care in new place-based partnerships.
• Trusts are also enthusiastic about the role ICSs can play to reduce health inequalities, invest in prevention, and provide a forum (via the integrated care partnership [ICP]) to engage constructively with social care and wider partners, in complement to their own roles.
• There is an important role for ICSs to play in driving up quality across the health and care system. Regulators have a key role to play in ensuring national frameworks support systems and trusts to prioritise continuous improvement and quality of care.