Although care boards support the government’s 10 Year Health Plan, ICB leaders remain concerned about redundancies and their strategic commissioning role.
Health systems are already making significant progress implementing the government’s NHS reforms, but urgently need clarity over funding for redundancies to continue moving forward, a new report has found.
The NHS Confederation has found that system leaders fully support the government’s Ten Year Health Plan, with more than half already making progress on the three key shifts from hospital to community, from analogue to digital, and from sickness to prevention.
Based on a survey of senior integrated care board (ICB) chief executives and chairs and integrated care partnership (ICP) chairs, the survey shows that there is strong support for the government’s reform agenda.
“Councils remain committed to working collaboratively with health partners during this period of considerable change. As the report highlights, health and local government are two sides of the same coin, with actions and decisions made by each side impacting the other,” responded Wendy Taylor, chair of the Local Government Association’s health and wellbeing committee.
“The report rightly highlights the positive legacy of integrated health and care over the past few years in tackling health inequalities and improving outcomes. It is vital that this legacy is built upon as the new neighbourhood health model is delivered,” she added.
Concerns remain
But the report also shows that ICB leaders are concerned that ICB redundancies and NHS reorganisation have created a significant distraction and barrier to systems’ progress. The government has asked ICBs to reduce their running costs by 50%, which will require significant redundancies at an estimated cost of £1 billion.
Almost all (95%) of ICB respondents said they were very or fairly concerned about the impact of the required cost reductions on their ability to deliver against national and system priorities. Until this issue is resolved, ICBs are, the report says, in limbo.
One ICB chair said that “all attention has been on the process of reorganisation itself”, which has impacted their ability to focus on the government’s three shifts.
The report also highlights that while ICBs are committed to their role as strategic commissioners, leaders say further support is needed to develop the skills and tools needed to fulfil their strategic commissioning role. This is especially related to how they can work with providers, shape the provider market, and understand the impact of services over a longer term so they can ensure they provide the best possible outcomes for local populations.
They are also concerned about the future of statutory responsibilities, such as all-age continuing care, safeguarding and medicines optimisation, which will remain with ICBs despite the shift in focus to strategic commissioning. ICB leaders are looking at how these can be delivered at this lower cost, but are concerned that they could potentially be subject to judicial review if they fail to meet statutory responsibilities they have not been resourced to deliver.
“ICS leaders are fully committed to implementing the government’s Ten Year Health Plan and making the key shifts it sets out… but they need further clarity, support and the right tools to do so,” said Sarah Walter, director of the NHS Confederation’s ICS Network. “Without urgent action to resolve funding for redundancies and provide strategic commissioning support, the NHS risks entering the next phase of reform on unstable footing,” she added.
