Step 1: Understanding the social and economic potential of the ICS

Summary

One of the significant strengths of the NHS is that it is everywhere. It plays an important, varied and active role in urban, metropolitan and rural economies; in those considered ‘highly-skilled’ and those often referred to as ‘left behind’. Our value may change depending on the local context, yet we can be confident that our decisions will have real-term and real-time implications for the local area. The inclusion of this as an ICS purpose has helped sound a national signal to local partners that this agenda matters – it is important systems now seek to build on this momentum.

Approach

It is possible to summarise the typical determinants of social and economic development where an ICS might begin to have an impact. These are as follows (table below), with guiding questions for local systems to themselves reflect on and answer:

Given the need to raise awareness among NHS leaders of their own potential impact, this list is intentionally focused on where the ICB’s statutory partners might make a difference.

Recommendations

• ICSs begin or accelerate their journey with a data-driven exercise across the typical determinants of social and economic development. Integrated care partnerships (ICPs) tasked with developing their integrated care strategies will benefit from this data trawl as they seek to understand the assets, strengths and needs locally and the issues to coalesce around to achieve wider impact.
• ICPs use this information to frame their internal understanding, shape new relationships with partners and provide something of a detailed baseline for future progress. This work can also help an ICP reimagine the scale of the impact its decision-making and investments can have on society locally. Over time, interactive forms of publishing this information in the public domain to support wider understanding can be developed, but this is not an immediate priority.
• ICPs compare this data with institutional anchor strategies from NHS and non-NHS organisations across the ICS geography where they exist. This will help to build on and challenge what has already been developed locally, understand common or potential areas of joint focus and priorities, and spread support to those yet to look in detail at this agenda. The ICS will have a leading role in moving from individual anchor strategies to a more connected anchor system. A broad partnership will better inform what institutions can strategically do for the given populations these varied organisations collectively serve, around which future strategic work can and should align.
• ICSs share the data within and across systems in thematic or geographic ways that can provide an important collective evidence base through which to support national change in select areas. For example, national NHS procurement guidance is often focused on what it perceives as scale and efficiency. Enabling an ICS to truly support local economies will require a greater understanding nationally of the power and value of local discretion. Strong regional or thematic ICS alliances on issues derived from this data must help change national policy for the better.