This section contains
Aims
Integrated care systems (ICSs) must be bold and ambitious. To improve population health in their area, systems must:
- have a clear vision and strategy in place
- design new care models in a person-centred way
- create a positive, empowering workplace culture for all teams in the ICS.
Context
Real change is needed to improve safety across the sector.
During the pandemic, system partners had to work together in new ways. Governance processes were simplified. Also, services adopted a "can-do, must-do" attitude that erased the barriers between them. System leaders should embrace the lessons learned from this challenging period. Especially now, as the sector shifts to a more collaborative, less competitive structure.
New models of person-centred care should be provided by a workforce that is empowered and inspired by the new ways of working. To help this happen:
- System leaders should collaborate to provide rapid and sustainable solutions to workforce challenges.
- Integrated Care Boards should distribute resources equitably across their systems.
It is also essential to be honest with people about how, when and where they will receive care. Margaret's experience shows how frustrating it can be to receive the wrong information. Prior to admission, she was told the emergency department was ready and waiting for her to arrive, but this was not the case. An unexpected lengthy wait ensued, causing stress for Margaret, Rachel and the emergency department staff who could not meet the expectation set.
Key suggestions
- Equalise pay, terms and conditions across the health and social care workforce.
- Shift from a primarily hospital-based model of urgent and emergency care, to one that provides more services in the community.
- Use person-centred design principles to deliver care that prioritises people's needs, not the system itself.
- Share accountability and learning as part of a joined-up safety culture.
- Create public information campaigns, so people know the right service to turn to when they need help.
- Be honest about when, where and how people will receive care. Build upon learning from the pandemic to simplify governance and bureaucracy.
- Use transformation funds that are affordable and already available for NHS commissioners. For example, the Better Care Fund (BCF).