Accelerating integration, building on the lessons of the pandemic

  • By Daniel Sheaff

Read about the system-wide review of health and care integration in London.

London Councils has partnered with PPL, the Greater London Authority, the NHS in London and the UK Health Security Agency to undertake a system-wide review, to enable health and care integration to build on the lessons and experiences of the pandemic. The outcome of this work sets out Five Ps (Purpose, Priorities, Place, Pounds and Providers) for integration. These Five Ps provide organising principles to describe London’s next steps to increasing integration in a meaningful way. Intrinsic to all of these is People - the sixth P.

Purpose – in our review we heard a strong response which said why can’t we make addressing inequalities the central purpose of London’s five ICSs? In practical terms, this could mean that we put addressing inequalities at the heart of how we fund, plan, deliver and assure services and how we measure the overall success of our ICSs and ICPs.

Priorities – people felt strongly that, as partners, we should agree in each place partnership a small number of priority outcomes linked to this purpose which we will deliver in the next 12 months. Perhaps priorities could be set at a borough level from a list of outcomes that can only be achieved by partners working together, based on the needs and priorities of all of our communities.

Place – In London we are now agreed, in the context of the health reforms, that Place means boroughs and that our 32 boroughs will be the heart of our local health and care systems. In practical terms, this would mean that place partnerships are enabled by ICSs who support them to have financial and decision-making autonomy, whilst enabling collective efforts on shared priorities and best practice.

Pounds – We found strong support for a commitment to pooling all local health and care budgets by default, except where there is a compelling reason not to. This would enable all partners to show how investment is growing in community-based prevention and early intervention, improving outcomes and reducing long-term costs.

Providers – We heard clear and consistent support for provider collaboratives and primary care networks to deliver better outcomes at scale and within places. In practical terms, this could mean that the voice of primary care is reflected in decision-making at all levels, with PCNs providing the “hub” for local care networks that focus on the wider needs of individuals and communities.

Daniel Sheaff, Principal Policy and Project Officer