Integration and whole-system thinking

Integration and whole system thinking

As COVID-19 pressures begin to subside, the integration of health and social care at a local level will need to go ‘further faster’, building on the relationships, structures and learning that have rapidly evolved during the pandemic. 

This theme will define and influence what system and place level working need to look like and how they should be best enabled from the perspective of our members.  

Prior to COVID-19, NHS England and NHS Improvement described 2020/21 as a year for delivering system by default in ‘shadow form’. The expectation was that all systems would achieve integrated care system (ICS) status by 31 March 2021. 

Members tell us that COVID-19 has significantly accelerated transformational change, much of which has been enabled by the structures and ways of working created through partnerships. Examples include significant re-shaping of acute care services at pace into ‘hot’ and ‘cold’ COVID-19 sites, digital transformation, shared leadership from health and care leaders, as well as changes to clinical pathways at a scale never previously seen. 

This theme will engage with members across the NHS and with local government to define and influence what effective system working should look like and how it should be enabled. Key themes will include:

  • authority and powers
  • influencing national policy around the move to ‘system by default’ 
  • the changing nature of accountability and regulation
  • shaping the future of clinical commissioning in the context of integrated systems 
  • exploring the role of place 
  • the changing role of providers 
  • exploring different leadership models
  • the role of primary care networks in neighbourhoods
  • the future financial architecture of the NHS and how to simplify payment systems
  • what patients think about some of the service integration that has been enabled at pace.

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