Integrated Care Systems
Integrated Care Systems (ICS) are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.
There are 42 ICSs across England, including Cheshire and Merseyside ICS, which will go live from 01 July 2022, when CCGs will be abolished.
The Cheshire and Merseyside ICS will bring together nine Clinical Commissioning Groups (CCGs):
- St Helens
- South Sefton
- Southport and Formby
The Cheshire and Merseyside ICS will have legal status and will include a statutory Integrated Care Partnership (ICP), and a new NHS body called the Integrated Care Board (ICB). These are described in more detail below.
Integrated Care Board (ICB)
Integrated Care Boards (ICBs) will be established as new statutory organisations to lead integration within the NHS.
The ICB will take on the NHS commissioning functions of CCGs as well as some of NHS England’s commissioning functions. It will also be accountable for NHS spend and performance within the system.
The Board of the ICB will, as a minimum, include a chair, the CEO and representatives from NHS providers, general practice and local authorities. Beyond that, ICBs will have the flexibility to determine governance arrangements in their area – including the ability to create committees and delegate functions to them. This would, for example, allow systems to create local ‘place’-based committees to plan care where appropriate. ICBs will also need to ensure they have appropriate clinical advice when making decisions.
NHS England will agree ICBs’ constitutions and will hold them to account for delivery.
Staff currently employed by CCGs will transfer to ICBs, and NHS England has made an employment commitment to staff to provide stability and minimise uncertainty.
Integrated Care Partnership (ICP)
Each area will also have an Integrated Care Partnership or ICP, a joint committee which brings together the ICB and their local authorities as equal partners, and other locally determined representatives (for example from health, social care, public health; and potentially others, such as housing providers).
The ICP will be tasked with developing a strategy to address the health, social care and public health needs of their system, and being a forum to support partnership working.
The Integrated Care Board and local authorities will have to have regard to ICP strategies when making decisions.
The ICB and ICP will also have to work closely with local Health and Wellbeing Boards (HWBs) as they have the experience as ‘place-based’ planners, and the ICB will be required to have regard to the Joint Strategic Needs Assessments and Joint Local Health and Wellbeing Strategies produced by HWBs.
The ICP will be a dedicated forum to enhance relationships between the leaders across the health and care system, interact with, and support the development of Place-Based Partnerships.
The Cheshire and Merseyside ICB will arrange for some of its functions to be delivered, and decisions about NHS funding to be made, in the region’s nine borough places – through Place-Based Partnerships.
Place-based partnerships are collaborative arrangements formed by the organisations responsible for arranging and delivering health and care services in a locality or community.
Place-based partnerships will remain as the foundations of integrated care systems as they are put on a statutory footing, building on existing local arrangements and relationships.
The ICB will remain accountable for NHS resources deployed at borough place-level. Each ICB will set out the role of designated Place-based leaders within its governance arrangements.
Providers of health, care and support services will increasingly collaborate at all levels of the system. This is nothing new; there are some great examples of joined-up provider working, especially during the Covid pandemic. However, the current rules don’t always encourage provider collaboration.
There are two separate Provider Collaboratives for Cheshire & Merseyside.
- The Cheshire and Merseyside Acute and Specialist Trust (CMAST)
- Mental Health, Community, Learning Disability collaborative (MHLDSC)
Both will agree specific objectives with the ICB, to contribute to the delivery of Cheshire and Merseyside’s strategic priorities and are committed to working together to support the delivery of benefits of scale and mutual aid across multiple places or systems.
For more information, visit the Cheshire and Merseyside Health and Care Partnership website
The Health and Care Partnership has also developed a glossary of terms to support understanding of both new and existing terminology relating to integrated care, which is available here.