NHS Confederation responds to the Hewitt Review

NHS Confederation representatives respond to the Hewitt Review.

3 April 2023

Responding to the Hewitt Review, Matthew Taylor, chief executive of the NHS Confederation said:

“I welcome Patricia’s review, and the recommendations she sets out.  

“While the foundations for Integrated Care Systems were set out in legislation last year, what we now need to see is a cultural and behavioural shift to make the best of these new structures - something this review will help to instigate.

“It is testament to the Review team's tenacity and hard work that a wide range of ICSs have been involved in the consultation process and reflects on the importance of seeing the health of the nation as more than the health service but as integral to a healthy and thriving society.

“The focus on prevention is crucial for long term sustainability of both the NHS and more broadly to increase health and wellbeing of the population, and something for which we have long been advocating.

“Through our ICS Network and its members, we look forward to continuing to help enable joint working between ICS leaders as recommended in the review and ensuring that ICSs can work closely with social care providers.

“We hope to see the government endorse and accept all of these recommendations, which are vital to the health and care system being able to meet the challenges and opportunities ahead.”

Gill Morgan, Chair of ICS Network Board at the NHS Confederation and ICB Chairs Network, responded:

“ICS leaders have shown widespread support for the review and have welcomed being so well engaged in the process, and that their contributions have been reflected in the recommendations.

“This review has also helped to formalise the behaviours and best practice already flourishing across many ICSs.

“It is right to focus on the prevention agenda and to highlight the additional resource ICSs will need if they are to move away from constant firefighting, to looking at the bigger picture and doing more to support overall population health and wellbeing.”

Responding on behalf of the NHS Confederation’s Mental Health Network, Chair Ifti Majid said:

“The Mental Health Network welcomes this important work, which has included good engagement with the mental health sector.

“Integration, not just across the NHS and social care sectors, is important for mental health, so it is essential that ICSs are enabled to be effective and meet their objectives and work with partners to deliver for their whole population.”

Rory Deighton, Director of the NHS Confederation’s Acute Network said:

"There is much in this review that acute leaders will welcome. Greater local autonomy, and a shift towards shared outcomes is a sensible approach. Leaders have been asking for a move towards multiyear recurrent funding for some time, and a long-term capital strategy is key.

“This review also correctly identifies the changed behaviours, cultures and operating environment that all stakeholders will need to make ICS succeed and improve care for our patients and communities.

“This winter has been incredibly difficult for the acute sector. Leaders now hope to see this reflected in the actions that unfold following the Review so that ICSs and acute leaders can work together to make next winter more manageable for everyone involved.”

Chair of the NHS Confederation’s Primary Care Network, Aruna Garcea responded:

“For ICS to succeed in their responsibility to reduce health inequalities and improve population health they need to be given the agency and capabilities to do so from national leaders. This review is a welcome recognition for the fundamental principles needed for success to become a reality.  

“The recommendation to review primary care contracts is something our network has long been campaigning for. The review has recognised how current contracts stifle primary care’s ability to innovate and integrate, and incentivises activity rather than outcomes. We welcome a review of supporting primary care to develop more agency and autonomy as partners in the ICS.

“We are also encouraged to see a recognition of the value of the partnership model as well as opportunities for new models to develop that can help stabilise the primary care system in the long term with support from ICBs.”

Hewitt review

Visit our Hewitt review section for commentary and analysis of the key findings and recommendations, including podcasts with Patricia Hewitt.