South Yorkshire has been chosen by NHS England as one of the first areas of the country to develop into an integrated care system.
An integrated care system is another way of describing the ambition we have locally, supported by our patients and staff, to co-ordinate care better. In an integrated care system, instead of many separate organisations all being responsible for individual health and care services, this would be more joined-up, with a single budget and a single set of health and care aims for everyone living in the region.
Being designated as an integrated care system means that we will be able to break down the barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS, giving our patients the seamless care they have told us they want.
On a practical level, being one of the first regions to develop new joined-up ways of working means that we can more easily tackle some of our priorities for change.
We will also lead the way in taking more control over the funding available from NHS England to support our plans for change as well as more freedom to make decisions over how the health and care system in our region will work in the future.
Since its creation in 1948 the NHS has constantly adapted and it must continue to do so as the world and our health needs change. We have many great people working in our services – and we want to support staff to continue to do an excellent job; providing safe care for everyone in the future.
There have been some big improvements in health and social care over the last 15 years. For example, people with cancer and heart conditions are experiencing better care and living longer. However, people’s needs have changed and they are generally living longer. They want their health and care services in a place and at a time that is right for them. For many, this means care that is provided at home, or in local healthcare centres - not in a hospital.
At the same time, people are waiting longer for treatment and spending lengthy periods of time in hospital when they could be at home, or seen by their GP or at a local healthcare centre.
Things can also seem unnecessarily complicated sometimes. For example, people having to repeat themselves to doctors, nurses and care workers and sometimes having to go to lots of different appointments in different places. This could work better and services could be more joined up and easier to understand and use.
There are some big staff challenges that we need to deal with. Even though in recent years the number of qualified clinical staff in the NHS rose by 3.9 per cent, there are not enough nationally for some services. As healthcare has developed, so has the role of doctors and nurses. Care and treatment can be provided by a wide range of healthcare professionals - not just doctors. Working like this would mean people being seen and treated more quickly.
We’ve got some tough financial pressures too which is mostly down to increased demand on services and people living longer. It’s a good thing that so many people are living longer but it means the way we work needs to change to meet the needs of an ageing population, so they can live well. We will also make the NHS more efficient.
Each ICS partner continues make decisions for its organisation. Collective decision making is made by the two alliances - the Provider Alliance and the Commissioner Alliance. They only do this when there is a regional problem or issue that needs solving for all the population.
There are a number of people working in the ICS. Almost all have been aligned to the ICS because the job they do in their organisation (one of the ICS partners) fits with the transformation work in the workstream.
The only new roles in the ICS are the programme director and lead.
Each of our individual partner organisations will remain accountable for their individual statutory responsibilities. This has not changed.
But being an “ICS” means that as a group of partners, we will also be accountable to each other and the local populations we provide services to.
As the ICS develops, we are starting to develop some formal shared accountability – so, for example, whilst our member organisations are responsible for meeting their own budgets, the ICS is gaining a responsibility for making sure that we keep within our overall regional budget. In this way, every individual hospital has a part to play in looking after the greater good. The ICS works very closely with NHS England and the Department of Health as we think through the tools we need to strengthen joint working.
The ICS has set out its commitments in a document called a “Memorandum of Understanding”.
The Sustainability and Transformation Plan (STP) for South Yorkshire and Bassetlaw, published in November 2016, lays out our original thinking in how we were going to work as a partnership, including our overarching ambitions for health and care services.
Because we were seen as ‘advanced’ by our national colleagues (e.g. NHS England), as a partnership working to deliver the STP, we were announced as one of the first areas to become an Integrated Care System. “ICS” has replaced “STP” as a name but our ambitions for the health and wellbeing of our population remains the same. All partners also remain the same and full list can be found here.
The STP talks about a £570m gap – which services are going to be cut to make this saving?
The £570m gap in the STP is not a “cut” or a “saving”. It’s the difference between the money we expect to have and the money we would need to spend if we didn’t change the way we work.
By working together more collaboratively and planning services together, using our workforce in the best way and in many cases, reducing duplication for the patient, we hope to narrow this gap.
Regardless of which political party is in government, the challenges facing the NHS nationally and locally remain the same which is why, as a partnership, we are keen to work together and develop joint solutions to issues which we have previously struggled to address alone. We think this is an excellent opportunity to develop more local solutions to strengthen our local services for local people.
We know we need to look at doing some things differently and we promise to keep you informed and involved. As we're just starting, there will be lots of opportunities for you to get involved and have your say.
There are a lot of workstreams, all looking at different areas of services. If you would like us to keep in touch about any of them, please email helloworkingtogether@nhs.net with:
- Your name
- Your email (or postal address)
- Your contact telephone number
- The workstream areas you are interested in
- Any special requirements for events
Reconfiguration refers to a change of organisation that delivers a service and/ or a change in where it is provided. This could be to improve services or to make sure they can continue to be safe.
For example Hyper Acute Stroke care was reconfigured as it was no longer delivered in Barnsley and Rotherham and patients are instead now treated in a different hospital in South Yorkshire and Bassetlaw.
Transformation is when we are looking at doing something differently to improve services, but in a way that doesn’t immediately and obviously impact on patients.
For example, hospitals working together more closely and doing things like agreeing to share staff rotas, agreeing to learn from each other so that all patients get the same high level of care.
Transformation can also include improving the range of services and patient choice available.
For example, providing more traditional hospital services closer to where people live in community venues, or providing people with information on how they could receive their care quicker at a different hospital if they would prefer to travel rather than wait.