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In a national, taxpayer-funded service, it is right that the Government and NHS England set out the outcomes that ICSs should be working towards. Partnership working needs to be about more than just collaboration if there is to be true integration within ICSs. We recommend that DHSC and NHS England provide more clarity about this and what action could be taken to resolve poor partnership working. While it is well established how ICSs will be held to account for NHS services, it is currently unclear how they will be held to account for partnership working. There also needs to be a recognition that accountability in the NHS is different to that in local authorities, and an effort made to ensure they work well together. To support this, NHS England and the Department of Health and Social Care (DHSC) need to adapt their approach, with NHS England in particular needing to move away from its centralised “command and control” approach. It is vital that social care is not forgotten, and that ICSs do not become too NHS centric. We share these concerns, particularly when it comes to the balance between accountability and autonomy that was the focus of our inquiry.Ĭollaborating well with partners will be the make-or-break factor in determining the success of ICSs.
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However, alongside the optimism are concerns that this potential will not be realised, and that, in a number of areas, there is a serious lack of clarity.
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We have been encouraged by the commitment to, and positivity about, the potential of ICSs. These systems are partnerships of organisations that are intended to offer a refreshed way of working across health, social care, wider local authority functions and voluntary, community and social enterprise organisations, to facilitate integration and to offer the flexibility to focus on the priorities that matter to local people. There is a lot of optimism about the 42 new statutory Integrated Care Systems (ICS).
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