Integrated care systems

Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England |  Chris Ham | The King’s Fund 


NHS England has recently changed the name of accountable care systems to integrated care systems. In this updated long read, Chris Ham looks at work under way in these systems and at NHS England’s proposals for an accountable care organisation contract.

The article looks at the following:

  • Why is change needed?
  • What are integrated care and population health?
  • What’s happening with new care models?
  • What’s happening in integrated care systems?
  • What are ACOs and why are they controversial?
  • How are integrated care systems and partnerships developing?
  • What has this way of working achieved?
  • What do these developments mean for commissioning?
  • Are these developments really a way of making cuts?
  • Will these developments lead to privatisation?
  • Where next?

The author concludes that integrated care should be supported as it is the best hope for the NHS and its partners to provide services to meet the needs of the growing and ageing population.

Full article: Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England



Refreshing NHS Plans for 2018/19

NHS England & NHS Improvement | Refreshing NHS Plans for 2018/19

This publication  responds to the November 2017 Budget announcement of additional NHS funding of  £1.6bn for 2018/19, which will increase funding for emergency & urgent care and elective surgery.


It outlines how additional funding will impact on frontline services such as primary care and A&E services. The Department of Health and Social Care (DHSC) is making a further £540 million available through the Mandate over the coming financial year.

It also sets out plans for the development of accountable care systems into integrated care systems. The guidance is accompanied by revised clinical commissioning group allocations for 2018/19.

The publication Refreshing NHS Plans for 2018/19 is here

A link to the revised CCG allocations is also available

Infographic to show CCG allocations are here


Supporting transformational change

Supporting Change In Your NHS: The Non-Executive Community In Transformational Change | NHS Clinical Commissoners | NHS England |  NHS Improvement

This joint publication with NHS England and NHS Improvement summarises discussions held at two events earlier this year that brought together more than 200 CCG lay members and trust non-executive directors. These events focused on how lay members and NEDs can contribute to the integration and transformation of their local health communities.

Full document available here


Integrating physical and mental health care

This article provides an overview of The King’s Fund ‘Integrating physical and mental health care learning network’ and how it helps translate a policy ambition to new models of care. It looks at the following questions:

  • Who comes to the network and how does it work?
  • What are the main challenges network members have in integrating physical and mental health care?
  • How has the network helped them to deal with these challenges?
  • What areas are people in the network focusing on to develop new models of care that integrate physical and mental health?

Find out more about the Integrating physical and mental health care learning network


Accountable care

Accountable care: policy fad or step forward on the journey towards integrated care? | Nicola Walsh |The Kings Fund

Accountable care is under discussion almost everywhere in the NHS. Groups of NHS providers (sometimes with the local commissioner) are exploring how they can work more closely together to take on the responsibility for the health and care of a given population within a given budget. Currently, we are seeing emerging accountable care arrangements adopting various forms according to local needs and preferences: in some areas the focus is on creating a single organisation; in others, organisations are keen to use the words ‘system’ or ‘partnership’ – to reinforce the notion of working together.

In this Kings Fund blog, Nicola Walsh looks in more detail at Accountable Care Systems and partnerships.


Getting into shape: Delivering a workforce for integrated care

This paper focuses on the structural barriers to delivering integrated care. It studies issues such as the medical labour market, devolved workforce planning and pay, and professional boundaries | Reform

Image source: Reform

The Government is rightly committed to a radical reshaping of NHS delivery, based on a shift to new care models and treatment in the community. Its management of the NHS workforce, however, has not delivered with nearly three times more doctors, and four times more nurses in the acute sector than in the community. Since 2009, the number of consultants has risen by nearly a third, whilst the number of GPs has fallen.
Freedom of Information requests made for this report found that, across 61 acute trusts, only 6 per cent of consultants work in the community for at least one session per week.

As the Government and the NHS leadership have repeatedly said, the priority for the NHS is to increase its speed of innovation. To do this, the NHS is rightly seeking to devolve decision-making and to deregulate. For the workforce, however, policy remains highly centralised and tightly regulated. This paper shows how to bring the same reform ideas to the workforce as the NHS is applying to other areas.


Hospital-Community Partnerships To Build A Culture Of Health

This compendium features detailed descriptions of hospital-community partnerships from across the United States that have made substantial improvement addressing priority health needs in their communities | American Hospital Association

Image source: AHA

These hospitals and communities vary in location, service type, type of partners and degree of partnership. All participated in Learning in Collaborative Communities, led by the Health Research & Educational Trust and supported by the Robert Wood Foundation.

Priority needs that the featured hospital-community partnerships are addressing include:

  • Chronic disease management
  • Health care access
  • Mental and behavioral health
  • Obesity
  • Preventive health practices
  • Social determinants of health
  • Substance use disorders
  • Violence

Partnerships are important because individuals and organizations share valuable insights, tools and resources. Lessons learned from successful partnerships motivate other partnerships to implement effective strategies in their organizations. The case studies in the compendium describe effective partnerships and programs to create a Culture of Health, their impact and lessons learned.

Read the full report here