NCL ICS Development

In April 2020 the five Clinical Commissioning Groups in North Central London (NCL CCGs) – Barnet, Camden, Enfield, Haringey and Islington – merged to form one CCG in line with the NHS Long Term Plan. Alongside this, borough partnerships have been formed in each borough to support working at a ‘place’ level and we have 32 thriving primary care networks across the area.

Since becoming a single CCG, we have continued to work closely with Councils, providers, general practices, voluntary and community organisations, to respond to the pandemic. We have also continued to progress towards a more strategic approach to commissioning across NCL and within our borough partnerships through continued work on population health, health inequalities and strategic reviews of services.

As part of the white paper, the next stage of this work is to transition to an integrated care system with the aims of:

  • improving outcomes in population health and healthcare
  • tackling inequalities in outcomes, experience and access
  • enhancing productivity and value for money
  • helping the NHS to support broader social and economic development.

Despite all of the challenges of the past few years, we have still managed to build stronger partnerships, relationships, and new ways of working as a system across social, primary and secondary care. 2020 informally made us think and act more like an ICS, aiming to deliver the best and seamless care for our population through the pandemic. We have already started focusing work on a number of areas.

  • A move to single strategic commissioner for health services.
  • Ensuring resident voice is heard at all levels of work.
  • Establishing five borough-based integrated care partnerships focused on the coordination, integration and development of out of hospital services based on population needs.
  • Supporting the development of Primary Care Networks.
  • Through our response to and recovery from the Covid-19 pandemic we have worked collaboratively with system partners to tackle challenges and find solutions to meet the needs of local people.
ICS System Development Plan

Our System Development Plan builds on the October 2021 version, with a focus on the core components of ICS development, as suggested by NHSE guidance. The document outlines our progress towards becoming a truly integrated care system that helps tackle health inequalities and improves access to health and social care for our residents across NCL. This document draws from existing engagement and planning across NCL to help establish a roadmap for our transition as a system.

ICS Design Framework

The ICS design framework has been produced through close collaboration with ICS leaders, a wide range of NHS organisations, representatives of patient groups, clinical and professional leaders, local government and the voluntary sector.

It builds on what is working well in ICSs across the country, and here in NCL. The framework also provides further clarity about the direction of travel and areas where consistency will be important, while allowing local flexibility to design systems in a way that will be most effective in each local area.

Alongside the framework, a summary document has also been published. Both are available on the NHS England and Improvement website.

Key guidance summaries

Following several years of locally-led development and based on the recommendations of NHS England and NHS
Improvement, the government has set out plans to put ICSs on a statutory footing. To support this transition, NHS
England and NHS Improvement are publishing guidance and resources, drawing on learning from all over the country,
with the aim of enabling local health and care leaders to build strong and effective ICSs in every part of England.

Purpose of this document

  • To summarise the essential guidance documents that form the building blocks of ICS development.
  • Key next steps for North Central London are included to ensure we build on the strong foundations.

Key Guidance Summaries

Health and Care Bill

In early July 2021, the government published a bill setting out how it intends to reform the delivery of health services and promote integration between health and care in England. This was the first major piece of primary legislation on health and care in England to be introduced to parliament since the Health and Social Care Act 2012.

The Health and Care Bill builds on the proposals for legislative change set out by NHS England in its Long Term Plan, while also incorporating valuable lessons learnt from the pandemic that will benefit both staff and patients.

The Bill includes specifications on how ICSs are to be set up and the distinct statutory functions for the ICB and integrated care partnership.

NHSE/I Guidance on the Employment Commitment

The NHS England and NHS Improvement executive paper Integrating care: next steps to building strong and effective integrated care systems across England and its accompanying letter to NHS leaders outlined an ‘employment commitment’ to colleagues directly affected by the proposed legislative change. The purpose of this commitment was to provide those people in organisations directly affected by the proposed legislative changes with employment stability throughout the transition period while minimising uncertainty as much as reasonably possible. The commitment is as follows:

  • Not to make significant changes to roles below Board level or roles that report directly to the Accountable Officer
  • To minimise the impact of organisational change on current staff by focusing on the continuation of existing good work through the transition and not amending terms and conditions of employment

Throughout the transition period, the employment commitment aims to ensure continuation of the good work being carried out by the current group of staff (below board level) is prioritised by minimising disruption. Further information can be found in the NHSEI Guidance on the Employment Commitment Report.

Information on the consultation with CCG staff on the proposed transfer of employment to the ICB is available here.