We must begin to shift the Integrated Care Systems' culture sooner rather than later

By Simon Edwards | 21 November 2022

Whilst a lot of focus – rightly so - has been on the immediate crises within the adult social care system as we head into winter, we cannot forget that the success of the health and social care integration agenda will go a long way to ensuring that social care services are ultimately put on a sustainable footing.

This year that agenda received a substantial fillip through the creation of Integrated Care Systems (ICSs), which offer huge potential to transform the ability for councils to work more strategically with their NHS colleagues at local level, building on initiatives such as the Better Care Fund.

In order to reflect on their progress to date, we have worked with IMPOWER to carry out an analysis of how ICSs were developing – crucially the first to do so from a local government, rather than a health, perspective.

The report was released on Monday and features the findings from a series of in-depth interviews and surveys with council leaders, chief executives, and Integrated Care Board chairs about their experience.

Partly as a result of ICSs being introduced when the NHS is under significant strain, and partly because of the centralising structure of the health services, many council leaders feel there is too much focus from ICSs on immediate health service pressures.

Arguably this is down to the decision makers, where only nine out of 91 Integrated Care Board members are councillors. As a result, just over half of councils say the extra time spent with health colleagues is justified.

The risk is that whilst they offer the best vehicle yet for collaboration, ICSs are still ultimately in de facto control by the NHS via Integrated Care Boards.  For them to be successful and deliver the outcomes we know are needed, County Councils Network members are clear that NHS colleagues need to demonstrate their commitment to working in an equal partnership. 

IMPOWER are clear that all is not lost and there is still enthusiasm from local government to make these new arrangements work. But we must begin to shift the culture sooner rather than later.

Simon Edwards is chief executive at the County Councils Network


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Adult social care County Councils Network ICSs