Demand for NHS services is rising rapidly as the population grows, ages and develops increasing complex needs. This pressure is increased by strained NHS funding and workforce shortages. To meet these challenges, the health and care system is transforming how it delivers care and moving towards managing population health in local areas.
In recent years, national NHS policy has shifted from a focus on competition between individual organisations to collaboration within integrated local health and care systems. Providers, commissioners and other system partners (local authorities, primary care and the voluntary sector) are working together to deliver preventative integrated care and, increasingly, take collective responsibility for performance and finances.
This vision was initially set out in The NHS five year forward view (2014), which set out the triple challenge of improving health equity, closing the financial gap and reducing unwarranted variation in quality. In 2017, NHS England published the Next steps on the five year forward view which set out a long-term role for system transformation over and above a time-limited planning framework. This was reinforced in the NHS long term plan, published in 2019, which placed system working at the heart of work to improve care quality, ensure services remain sustainable and shift the emphasis to prevention and population health approaches.
In recent years, sustainability and transformation partnerships (STPs), integrated care systems (ICSs) and primary care networks have emerged as the key mechanisms for delivering this agenda at system, place and neighbourhood level. There are currently 42 footprints covering the whole of England, of which 14 are ICSs (including two devolution areas) and 28 are STPs.
This rapidly evolving national policy context leaves some unanswered questions in relation to regulation and oversight, the role of commissioning, and governance arrangements, which will have major implications for how our members operate. NHS trusts and foundation trusts are playing a key role in designing new integrated care models, setting strategic direction and joining up services across the system. As we move towards all STPs becoming ICSs by April 2021, NHS Providers will continue to support members to navigate the complexity of system working and integrated care, share learning and best practice across the country, and influence national policy developments.
More information can be found in the resources section below, as well as blogs, press releases and reports that we have produced on the topic.