Integrated care systems need to be different - but how exactly?

ICSs are intended to be a fundamental departure from previous NHS structures with a different type of leadership based on partnership, in which local partner organisations hold collective responsibility for resource use and outcomes. However, as ICSs take on statutory responsibilities for the first time later this year (assuming the Heath and Care Bill gains parliamentary approval) there is a risk of recreating established ways of working within the new structures. To live up to their promise, what are the things that should be ‘different’ about ICSs?

First, the concept of equal partnership between the NHS, local government, voluntary sector and others needs to be at the core of how these reforms are implemented. ICSs started their lives as informal partnerships operating through soft power and influence. The Health and Care Bill changes this by putting ICSs on a statutory footing, but partnership-working and collective responsibility need to remain at ...