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



What does the Autumn Budget mean for the NHS and social care?

In the budget this week, the Chancellor committed around £2 billion extra for the NHS next year. Nigel Edwards of the Nuffield Trust said this will bring respite for patients and staff, but is only around half of what’s needed.

In a Q&A about the budget, Tom Moberly, The BMJ’s UK editor, met with John Appleby (Nuffield Trust), Anita Charlesworth (Health Foundation) and Siva Anandaciva (King’s Fund) to discuss what it all means for the NHS and social care. You can watch the discussion below:

Quality improvement

Establishing quality improvement approaches which actually work has much to do with suitable leadership and organisational culture, according to a new King’s Fund report.


This report explores the factors that have helped organisations to launch a quality improvement strategy and sustain a focus on quality improvement. It identifies three common themes for successfully launching a quality improvement strategy: having a clear rationale; ensuring staff are ready for change; understanding the implications for the organisation’s leadership team in terms of style and role.

The report finds that NHS leaders play a key role in creating the right conditions for
quality improvement. Leaders need to engage with staff, empower frontline teams to
develop solutions, and ensure that there is an appropriate infrastructure in place to
support staff and spread learning.

Full reference: Jabbal, J| Embedding a culture of quality improvement | Kings Fund


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.


Quality improvement

Making the case for quality improvement: lessons for NHS boards and leaders | The King’s Fund | The Health Foundation

This briefing outlines the following ten lessons for NHS leaders which provide a starting point for those seeking to embed quality improvement in their work:

  • Make quality improvement a leadership priority for boards.
  • Share responsibility for quality improvement with leaders at all levels.
  • Don’t look for magic bullets or quick fixes.
  • Develop the skills and capabilities for improvement.
  • Have a consistent and coherent approach to quality improvement.
  • Use data effectively.
  • Focus on relationships and culture.
  • Enable and support frontline staff to engage in quality improvement.
  • Involve patients, service users and carers.
  • Work as a system.

The briefing makes the case for quality improvement to be at the heart of local plans for redesigning NHS services.

Full report available here


Sustainability and transformation plans in London

Sustainability and transformation plans in London: an independent analysis of the October 2016 STPs | The Kings Fund | Nuffield Trust


This report looks at the five Sustainability and Transformation Plans in London, their contents and common themes.  The authors, from The King’s Fund and the Nuffield Trust, assess the main issues and risks to be addressed across the plans. They make a small number of recommendations for the future of the STP process in London, focusing specifically on the role of London-wide action in taking forward the plans.  The report includes a brief update on progress since March 2017.

Download the full report here


NHS standards and performance: is prioritisation the answer?

The Kings Fund June 2017 quarterly monitoring report (QMR) showed that NHS performance on key access targets over the financial year 2016/17 continued to deteriorate. In this new blog James Thompson asks whether a combination of increased funding, incentives and pressure from the centre will be enough to get A&E waiting time targets back on track.