The experience of tackling the immediate crisis of the COVID-19 pandemic has shaped the views of ICS and STP leaders that system and partnership working needs to be strengthened.
A new report from the NHS Confederation’s ICS Network, based on a poll of around half of England’s ICS and STP leaders and independent chairs, reveals the majority support widespread new powers for systems in the aftermath of the pandemic.
The report Time to be radical? The view from system leaders on the future of ‘system by default’ forms part of the NHS Confederation’s NHS Reset campaign, which contributes to the public debate on what the health and care system should look like in the aftermath of the COVID-19 crisis.
The report demonstrates that since the outbreak of the pandemic there has been a growing appetite among system leaders for significant strengthening of system working, with an increasing number favouring a move away from the current ‘voluntary partnerships’ approach in favour of more formalised working arrangements.
As the questions in the poll do not allow for finer detail or nuance, further work is needed to understand the fuller views of ICS and STP leaders, as well as the wider members of the NHS Confederation, including providers of primary, community and secondary care, commissioners, local government and the community and voluntary sectors. As such these findings are intended to offer a platform for further discussion on what the future approach to ‘system by default’ might look like, rather than them representing the membership body’s definitive policy position.
Over the coming months, the NHS Confederation will explore the areas covered in this report in more detail with a wider constituency of its members and partners. This will help to identify where there is consensus and disagreement on particular issues and proposals.
Niall Dickson, chief executive of the NHS Confederation, said:
“There has been a definite shift of opinion among STP/ICS leaders. There Is now much more support for legal powers to be vested at system level and an overwhelming desire to bring health and social care funding together.
“There is also a clear frustration that STPs and ICSs are viewed by the centre essentially as outposts of the NHS, whereas the vast majority of leaders see themselves as being part of a joint endeavour with local government.
“There is a huge amount to play for here. Structures and powers are never a panacea or a guarantee of effective working, but there is general agreement that the current arrangements will not do. We now have a great opportunity to shape a health and care system that can deliver joined up services.
“This report reflects these changing opinions – they come from some of the most senior figures in the NHS and must be listened to. At the Confederation, we will be exploring these ideas in more detail with government and arms-length bodies and we will work with all our members across the service and with our partners in local government to support the development of an effective structure and approach for the NHS in England.”