Hewitt review

Exploring how the oversight and governance of ICSs can best enable them to succeed, balancing greater autonomy and robust accountability.
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In December 2022, Patricia Hewitt, chair of Norfolk and Waveney Integrated Care Board, began a review of the oversight, governance and accountability of integrated care systems (ICSs).

The final report, released in April 2023, proposes greater autonomy to enable ICSs to better prevent ill health and improve NHS productivity and care, matched by renewed accountability.  

If fully implemented, the review’s recommendations offer a step change in enabling ICSs to deliver their four main statutory purposes.

Recommendations include:

  • fewer central targets
  • enabling a shift towards upstream investment in prevention
  • multi-year funding
  • payment mechanism flexibility
  • reconsidering cuts to the running cost allowance. 

This section brings together our summary and analysis of the key findings and recommendations, wider commentary on ICS autonomy and accountability and podcasts featuring Patricia Hewitt and NHS Confederation chief executive, Matthew Taylor.