Getting integrated care systems right: challenges and opportunities

Photo by Priscilla Du Preez on Unsplash

Julie Bass, Chief Executive at Turning Point, explores the challenges posed by Integrated Care Systems (ICSs).

It’s official – Integrated Care Systems (ICSs) are now here as statutory bodies and there is great opportunity to utilise a system-wide approach to integrate care, improve population health, and reduce disparities. However, the present environment will prove challenging terrain for the 42 new ICSs to navigate.

The demand for services is rising – with recent figures showing increasing ambulance waiting times, deepening elective care backlogs (currently 6.84 million people), and the fact the number of people waiting for community mental health care has risen to 1.2 million.

Meanwhile, the cost of living crisis is cutting into department budgets and workforce shortages have reached a record high – the Expert Panel health and social care workforce report emphasises the lack of a workforce strategy at a national and local level. Together, these pressures threaten a ‘winter health service emergency’.

These realities have begun to translate into public pessimism regarding the state of the NHS – with a recent study by the Health Foundation finding that a majority of people think the general standard of care has worsened in the past 12 months in health (55%) and social care (56%). It is important to note, however, that whilst the public wants a better health service, there is no appetite for a departure from the NHS model.

These challenges strengthen the call for an integrated response from services across the health and social care system – and ICSs are well positioned to facilitate this – yet given escalating pressures there is the risk that ‘ICSs won’t be given the chance to succeed.’

Tackling mental health

An essential focus for newly established Integrated Care Boards (ICBs) is promoting an increased level of parity for mental health. Issues with mental health service provision run deep – with a paucity of community and crisis services, chronic under-investment, and bed shortages – increasing pressures on emergency departments.

The key to achieving parity for mental health is recognising that it is deeply entwined with many other factors impacting our day-to-day lives, including debt and finances, employment, and access to housing or benefits.

Any plan addressing mental health therefore has to detail how multiple parties will come together to put mental health at the very centre of everything they do, particularly against the backdrop of the pandemic and the unfolding cost-of-living crisis. Back in August, 17 mental health groups (including the Association of Mental Health Providers of which Turning Point is a member organisation) penned an open letter to the government on this topic. Such a plan needs to be a top priority for both ICSs and Thérèse Coffey as the new Health Secretary.

Reducing health inequality

In the decade leading up to the pandemic, improvement in health across the UK slowed substantially – with widening inequality, and the health outcomes of the poorest in society worsening.

ICSs are now being tasked with leading efforts to identify and reduce health inequalities within their geography, combined with wider aims of improving population health and contributing to social and economic growth.

Despite the challenges across the country, there are some great examples of place-based partnerships taking action on the prevention agenda, reaching people with multiple and complex needs, who in the past, have fallen through the gaps.

Read the full blog post here.


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We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Turning Point

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