Scope of an IHO

The 10YHP states that IHO host providers will have the opportunity to ‘hold the whole health budget for a defined local population’. One of the founding features of capitated contracts is that they cover people from cradle to grave, providing an incentive to prevent ill health along a life course. 

Healthcare leaders feel strongly the scope of an IHO contract should be defined locally by ICBs and providers, based on the IHO’s agreed purpose, local geography, patient flows, existing provider configuration and population need. A local approach will be taken to defining neighbourhood contract boundaries. Alignment across these footprints will be crucial so that ICBs can set consistent outcomes (this link is explored further in section 2.1).

Local leaders suggested a range of potential population sizes. Typically, we expect an IHO contract will serve a place or unitary authority footprint (250,000-500,000 people) but could also extend to a borough or provider collaborative scale (1-1.5 million people). These footprints are generally smaller than ICSs while remaining large enough to cover a meaningful range of services and populations. Some suggested starting small and building up.