Agenda item

The Integrated Care System (ICS) Design Framework, published on 16th June 2021, sets out the next level of detail on the NHS’s expectations and ambitions for ICSs from April 2022.  The Committee will hear how this will impact on the Buckinghamshire, Oxfordshire and Berkshire West ICS – at both system and local level.



Dr James Kent, Accountable Officer



Presentation attached


The Chairman welcomed Dr James Kent, ICS Accountable Officer, to the meeting. Dr Kent provided an overview on how the Integrated Care System (ICS) Design Framework would impact the Buckinghamshire, Oxfordshire and Berkshire West ICS at system and local level. The framework would continue the system work that had been carried out over the past 2-3 years. Benefits of further joint working had been highlighted during the pandemic and the removal of the competitive market would encourage further collaboration. Making ICS a statutory body aimed to improve health outcomes for patients, including by enabling focus on the entire health pathway rather than segments of it. The Paper outlined the design framework and further detailed guidance on how it should be run locally was expected. It was also expected that the ICS model would be introduced in April 2022 following the legislation being passed in Parliament. 


Part of creating the ICS as a statutory body would involve the safe transfer of the statutory duties of the three CCGs – including Buckinghamshire into this single organisation.  Further clarity was expected on the mechanism for local place support and local fund delegation by the end of September. Alongside this, the ICS was working on proposals for the governance arrangements, including delegation to place level.


The following points were raised during Member discussion:


·       Central Government would fund the ICS who would then delegate this down to place level. This detail was still being worked through. Members were concerned about the funding arrangements and the Select Committee would monitor this when more information became available.  

·       International healthcare models had informed the national strategy, some of which were from Singapore and USA, and showed the potential to improve patient outcomes and quality of care by allocating resources into a single pathway. Currently in the case of cardiac care, for example, there were different budgets allocated to prevention, primary, secondary, and tertiary care.

·       The measures would roll back competition changes that had been introduced via the Lansley Act.

·       There was currently a set of 75 metrics, in draft form, that the ICS would be measured against. It was also possible that the CQC may inspect ICSs. Other programmes may also be introduced with their own metrics (e.g. smoking cessation).

·       Engagement was taking place with broad stakeholders, such as Buckinghamshire Council, and health stakeholders, including Primary Care. This would inform the governance arrangements. Local public engagement would then be planned ahead of the changes in April 2022. It was noted that the changes would be around management and commissioning structures not patient services.

·       Place based partnerships were still being designed but the current thinking was to strengthen the Primary Care Networks (PCNs) and increase their resources to develop closer locality partnerships. The Chairman noted that the Committee had monitored PCNS for 2-3 years.

·       Future changes to adult social care were separate to the statutory introduction of ICSs. Changes to care funding may become clearer in the Government’s spending review.

·       Consultants currently supported work on the design of place delegation and governance. They had not been commissioned to work on funding flow but may do in future due to timescales and gaps in skillsets.

·       Dr Kent agreed to provide Members with useful links to both national and international reports on Integrated Care Systems.


The Chairman thanked Dr Kent for attending and for discussing the latest ICS developments.

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