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Integrated care systems to take key population health decisions

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Integrated care systems (ICSs) will be rolled out across the country by 2021, the NHS long-term plan says.

The plan published today says ICSs will emerge from current sustainability and transformation partnerships and “have a key role in working with local authorities at ‘place’ level”.

It adds commissioners will “make shared decisions on how to use resources, design services and improve population health”.

This will involve “streamlined” arrangements to “enable a single set of commissioning decisions at system level”.

The plan adds: “This will typically involve a single CCG [clinical commissioning group] for each ICS area.

“CCGs will become leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health, service redesign and long term plan implementation.”

Each ICS will have a single partnership board, representing commissioners, trusts, primary care networks, as well as councils, the voluntary and community sector and other partners, “with the clear expectation that they will wish to participate”.

Potential new “licence conditions” could be created, “supporting NHS providers to take responsibility, with system partners, for wider objectives in relation to use of NHS resources and population health; and b) longer-term NHS contracts with all providers, that include clear requirements to collaborate in support of system objectives,” the plan says.

An integrated care provider (ICP) contract will be created this year, following consultation. This, the plan says, will allow “for the first time the contractual integration of primary medical services with other services and creates greater flexibility to achieve full integration of care”.

The plan says a new ICS accountability and performance framework will “consolidate the current amalgam of local accountability arrangements and provide a consistent and comparable set of performance measures”.

It adds the government has committed [through the NHS funding settlement] “to ensure that adult social care funding is such that it does not impose any additional pressure on the NHS over the coming five years”.

“That is basis on which the demand, activity and funding in this long term plan have been assessed,” the plan says.

A review of the better care fund will be published shortly “to ensure it meets its goals”.

Funding in 2019-20 will include clear requirements to continue to reduce delayed transfers of care and “improve the availability of care packages for patients ready to leave hospital”.

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