Step 3: Securing partners, leveraging policy, unlocking funding programmes

Summary

Building and implementing a cycle across an ICS that identifies a set of common priorities can enable a strong spirit of collaboration to run through the system. There remains, however, a lack of confidence for many in the NHS about engaging in, and supporting, the wider social and economic agenda. While this is perhaps understandable, it is important to recognise the skills and insight across the ICP, and importantly, that an ICB should not be approaching these common issues alone.

The emerging economic and social landscape across the country is complex. The levelling up white paper, published in February 2022, outlined for the first time a formal framework for devolution setting out what powers areas in England can over time gain and how. At present it is possible for an ICS to have within its footprint a Mayoral Combined Authority (MCA), a range of other tiers of local government and a local enterprise partnership (LEP) all involved in policy and delivery. While it can be challenging for these organisations themselves to organise in a way which best formulates a coherent economic and social plan for the locality, other partners such as the ICS, universities, colleges, VCSE organisations and industry can act as brokers in local discussions.

While this patchwork exists, a clear national direction on the partners, policies and funding programmes necessary to enable an ICS to deliver on its chosen priorities is not practical or helpful. Nevertheless, it is possible to highlight, as below, the types of organisations, both traditional and otherwise, that the different layers of the new health and care structure would be best-served establishing relationships with to co-deliver on this purpose. For some, this ICS purpose will itself give purpose to the partnerships a system develops, particularly where previous engagement was limited.

A common message from partners was the need to demystify how the health and care sector works. If people do not understand the NHS, for example, they will expect or ask for things that are unrealistic and miss potential opportunities where we can add real value. In this case, we all lose out. We can also reference some of the policies that may or may not be new to an ICS and the variety of funding programmes and other resources they, the ICB and partners wish to draw on.

Approach

Assessing progress against this table, and seeking out who is interested in shaping, stretching and resourcing local activity relating to the transformational priorities, represents the third step in the model framing.

This table will change over time but is a good starter to reflect on as systems cast the net wide in search of partners, policies and programmes that can support their priorities and pilots.

Recommendations

• ICPs nominate a lead for the ICS purpose of supporting social and economic development, whose role is to understand the emerging landscape and the partners, policies and funding programmes that can support activity. This lead can act as a single-entry point for external partners and will be vital in being at the various tables as discussions locally progress and in looking for testable propositions to build on the transformational questions now being asked. Depending on the priorities under review for the integrated care strategy this horizon-scanning will enable critical connections to be made that can determine where change can be driven. There is certainly a critical lead role for local government in this work. Leaders who understand their communities, and whose portfolios are much broader than health, can help make connections across the local economy.
• ICPs use the guiding social and economic checklist to follow when initiating local programmes of work. The ten questions to the right are intended to help leaders to make decisions that are right for their system and population.
  
  It is likely that the awareness of the external context in which an ICS operates will grow as its leadership is exposed to a series of new conversations and partnerships, which will in turn have positive and wide-ranging implications for the future evolution of integrated care strategy and potentially the governance mechanisms that drive local policy and decision-making. Nevertheless, there is a clearly an important role for national health and care bodies such as the NHS Confederation, Local Government Association and others to support ICS leaders to understand better their local economy and to have more productive conversations with local organisations and their leaders around where to focus NHS resources.