The move to creating a statutory Integrated Care Board in North Central London is welcome. The long-standing challenges facing the five boroughs have been exacerbated by the Covid-19 pandemic and the stark inequalities that determine resident’s life chances have never been more exposed.
Whilst organisations themselves do not solve these problems, the people they employ, the culture they create and the purpose they define must be targeted directly at supporting individuals to navigate the complexities that may be preventing them from living long and healthy lives. We know that health problems can often be traced back to the very early stages of life, before an individual ever requires a hospital admission. We know that many of the causes of ill health can be prevented through better education, better housing, improved community spaces, meaningful work and individual determinism. This alone explains why no NHS institution or practitioner can be successful in isolation and that only through creating common purpose with our local authority partners, the voluntary, community and social enterprise sector, individuals, communities, and local businesses can we hope to address these long-term challenges.
We have hospitals, community, mental health and primary care services that employ the highest calibre of individuals who have worked tirelessly to meet the needs of our communities. We know that our workforce is tired, and that staff are often frustrated by the bureaucracy that may take them away from patient care or result in duplication across organisations where better ways of distributing resources are apparent.
We recognise that there is too much short-termism in the NHS when chronic problems such as obesity, cancer and heart disease need more generational overview. As an ICS, we will commit to ensuring the right start in life, to enabling individuals to thrive with lives to be well lived and to hospital care being available for those who need it.
We know that our ambition must be supported by digital and infrastructure arrangements that break down barriers and give residents more control of their own lives. We know that embedding the NHS further in our communities, creating anchor organisations and building support for communities will have long term health benefits.
We know that we have to move away from episodic spend to spending money over the lifetime of individuals to manage longer life expectancy and the impact of long term and chronic illness; this can only be done through a population health approach, understanding need in the context of individuals lives, families and communities.
In North Central London, we have the ingredients to make this change to embed our long-term goals – excellent services, a committed workforce, a willing leadership and a shared belief in the urgent need for change.
We want to create networks of support for everyone who needs it, ensuring no one is left behind and a health and care system that is subject to continuous and ongoing improvement and academic evaluation.
This is our opportunity for real change; we must take it.
Diversity, Inclusion and Belonging
In NCL CCG, we recognise the importance of diversity, inclusion, and belonging. We want everyone to feel welcomed, respected, and accepted for who they are. This is why we have been working hard with our diversity Staff Networks, senior managers, Governing Body Members, and external stakeholders to promote, diversity inclusion and belonging. “See ME First” is our new initiative led by our Staff Networks that brings the person to the fore and lets them be seen, accepted, and respected for who they are.
We have made significant progress in the last few years in our inclusion, both for patients and communities and our workforce. As we embark on a transition to ICB/ICS, we expect very high standards from our senior leaders- demonstrating strong personal and professional commitments to our Values and the NHS Constitution and making continuous improvements in our inclusion performance through which they can be held to account.
The five boroughs at a glance
Estimated Population: 396,000
Primary Care Networks: 7
Federation: Barnet Federated GPs
Estimated Population: 334,000
Primary Care Networks: 4
Federation: Enfield GP Federation
Estimated Population: 269,000
Primary Care Networks: 8
Federation: Federated 4 Health
Estimated Population: 242,000
Primary Care Networks: 4
Federation: Islington GP Federation
Estimated Population: 270,000
Primary Care Networks: 7
Federation: Haverstock Healthcare & Camden Health Evolution (CHE)
About Integrated Care Systems
Integrated care systems (ICSs) are geographically based partnerships that bring together providers and commissioners of NHS services with local authorities and other local partners to plan, co-ordinate and commission health and care services. They are part of a fundamental shift in the way the health and care system is organised – away from competition and organisational autonomy and towards collaboration, with health and care organisations working together to integrate services and improve population health. ICSs have been developing for several years – the Health and Care Bill will put them on a statutory footing from April 2022.
Within the ICS in North Central London, we will establish an Integrated Care Board (ICB) that will take on the NHS planning functions currently held by the CCG and will also take on additional planning and commissioning functions that currently sit with NHS England. We are now in the process of establishing the senior leadership team for the NHS North Central London Integrated Care Board, following the appointments of a Chair (Mike Cooke) and Chief Executive Officer (Frances O’Callaghan) in 2021. The four core purposes of an ICS are to improve outcomes in population health and healthcare; tackle inequalities in outcomes, experience and access; enhance productivity and value for money and help the NHS support broader social and economic development, all rooted in underlying principles of subsidiarity and collaboration. Further details of the operation of ICSs is set out in the ICS Design Framework.
The ICS is expected to be a statutory organisation from 1 July 2022, responsible for specific functions that enable it to deliver against the four core purposes. The board of the ICB will be a unitary board, responsible for ensuring that the body meets its statutory duties including the triple aim duty for all NHS organisations of better health for the whole population, better quality care for all patients and sustainable services for the taxpayer.