Toolkit

Quantifying the left shift for the NHS: ICS investment tool

Understanding the breakdown of healthcare spend per capita and the potential savings from increasing spend in the community care setting.

3 March 2025

As the government seeks to turn around the NHS and achieve a ‘left shift’ from reactive care in hospitals to more proactive care in the community setting, improved insights about spend and allocation is critical. 

Our investment tool, developed by CF in partnership with the NHS Confederation, has been created to support integrated care systems (ICSs) to understand and scrutinise the breakdown of healthcare spend per capita, and the potential savings and return on investment by increasing spend in the community care setting.

The tool enables better understanding of:

  1. The level of spend per capita compared to needs per capita for each of primary care, community care, mental health and acute. 
  2. The potential impact that increasing community spending could have on acute.

This follows on from our joint report on the impact of investing in community spend, which demonstrated the potential to reduce acute activity. 

How to use the tool

  1. Select an ICS from the dropdown box in the top right-hand corner
  2. Explore an overview of the ICSs spend distribution in acute, primary, community care and mental health; comparable to peer data 
  3. Scroll down to adjust spend in community care. This reveals the potential ROI from altering spend distribution, highlighting the impact on GVA, and the possible overall economic return.

This tool should help you explore questions such as:

  • How is spend currently allocated by care setting in my ICS?

  • Is this the right distribution of spend based on population needs?

  • How does this spend compare to my peers?

  • If my ICS invested more in community care, what could the impact be? 

These insights provide just a glimpse into the potential of investing more in community care and moving the NHS to a proactive care model. If you’d like to understand more about the ICS tool or any of its insights, please get in touch.

Limitations of the tool 

This tool uses the most recent national data for whole years available at the time it was created. It is designed to show spend and need and illustrate potential impact based on the relationship established in our report. It does not enable wider return on investment to be calculated and it does not reflect the detail of spending by intervention outlined in our prevention report.

  • NHS Confederation

    The NHS Confederation is the membership body that brings together and speaks on behalf of organisations that plan, commission and provide NHS services in England, Northern Ireland and Wales. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.

    CF

    We are a leading consultancy dedicated to making an enduring impact on health and healthcare. We work with leaders and frontline teams to improve health, transform healthcare, embed life science innovation and boost growth through investment. With unmatched access to UK healthcare data and award-winning data science expertise, our team are a driving force for delivering positive and meaningful change. For more information, visit our website.