Health
NHS Confederation backs legislation to embed joint working across health and care

By - Integrated Care Journal

NHS leaders call on the Government to introduce a legal framework for integrated care systems following the successful collaboration seen during the Covid-19 pandemic.


A report published recently by NHS Confederation revealed broad support across its membership for giving integrated care systems a statutory footing in law. This call for enshrining more collaborative working practices in law comes ahead of the Government’s expected introduction of new primary legislation affecting the NHS over the coming year.

Legislation that embeds partnership working across health and care services would reduce the long-standing fragmentation between NHS services and a wide range of other health and care organisations including local government, community and voluntary organisations.

NHS leaders believe the Covid-19 pandemic has demonstrated the positive effects of these collaborations between NHS services and other health and care organisations.

Danny Mortimer, Chief Executive of the NHS Confederation, said that this increase in collaborative working “has resulted in lean, agile and responsive health and care, and we must seek to embed this for the long term”.


In the report, the NHS leaders largely agree that the purpose of an integrated care system enshrined in law should be:

  • to deliver improvement in the health outcomes of their populations 
  • to reduce health inequalities 
  • to integrate primary, community and secondary services, physical and mental health services and health with care 
  • to improve the quality of health and care services and the reduction of unwarranted variation
  • to ensure efficiency and efficacy in how funds and resources are allocated.

The report made clear that it is paramount that whatever form integrated care systems adopt through the statute, they must embed partnership working across the wide range of organisations involved in health and care. Systems must not simply be delivery arms of the NHS system. Instead, they must continue to develop as partnerships of organisations working to deliver improved health and wellbeing in their local communities.

Eight out of 10 of the NHS leaders surveyed agreed that a shared statutory duty needs to be placed on NHS trusts, foundation trusts, CCGs, local authorities and other system partners to build on partnership working where it will benefit their patients. This also means developing a shared sense of accountability for improving population-level outcomes and incentivise joint-commissioning.

The NHS leaders surveyed also called for a radical reform of oversight models. The Covid-19 pandemic has shown that a reduced regulatory burden is conducive to rapid innovation in the NHS, prompting calls for a lighter oversight model to be built into the NHS permanently.
 
Speaking to the NHS Confederation, however, NHS leaders cautioned that giving integrated care systems statutory footing must not be rushed. In order to allow for careful planning and the ironing out of any local issues, integrated care systems should operate in shadow form for a significant period of time.


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