Hewitt review

Exploring how the oversight and governance of ICSs can best enable them to succeed, balancing greater autonomy and robust accountability.

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.

Featured

A sign reading "Whitehall, SW1, City of Westminster".

The government’s response to the Hewitt review and the Health and Social Care Select Committee report

Summary and analysis of the government's response to the Hewitt review, and to the Health and Social Care Select Committee's inquiry into ICSs.

20 June 2023

A hospital corridor

Hewitt review: what you need to know

Summary and analysis of Rt Hon Patricia Hewitt's review into the oversight, governance and accountability of integrated care systems (ICSs).

4 April 2023

News and comment

An NHS outpatients sign outside of a hospital.

NHS Confederation reacts to government's response to Hewitt Review

Matthew Taylor chief executive of the NHS Confederation comments on the government's response to the Hewitt Review

14 June 2023

An NHS sign on the side of a building.

NHS Confederation responds to the Hewitt Review

NHS Confederation representatives respond to the Hewitt Review.

3 April 2023

ICS Network’s support for the Hewitt review's proposals

Joint letter endorses the principles and proposals of the Hewitt review and urges the Secretary of State to implement them as soon as possible.

4 April 2023

NHS Voices blogs

The NHS has warmed to Barclay, but his biggest test is to come

What the new reforms proposed by the Hewitt review will mean for the NHS and population health outcomes.

29 March 2023

Publications

People connected by lines

Accountability and autonomy in the NHS in England

Sir Chris Ham reflects on progress made against his recommendations on the conditions ICSs need to succeed and on next steps for the Hewitt review.

5 January 2023

A hospital corridor.

Governing the health and care system in England

Where will system leadership and partnership working fit into the new operating model, and will commitments to devolve decision-making be fulfilled?

23 February 2022

Podcasts

Patricia Hewitt: There’s a real chance to tackle health differently this time

Patricia Hewitt on how integrated care systems can support people to live longer, healthier and happier lives.

4 April 2023

Patricia Hewitt: Influencing the way ICSs work and how the centre works with them

Patricia Hewitt on integrated care system (ICS) oversight and governance and the critical enablers systems need to succeed.

11 January 2023

Contact us

Edward Jones

Senior Policy Adviser

Edward works on policy within the ICS Network Team but previously worked at a public affairs agency where he specialised in health policy.

Annie Bliss

Annie leads on system oversight and accountability as well as key areas like system transformation and the COVID-19 response.