NHSEI has recommended that Parliament pass legislation repealing the current rules governing the provision of health services by the NHS. and that these will be replaced by a new scheme created specifically for the NHS. NHSEI recently consulted on the new vendor selection system, which would give decision-makers greater latitude in service design, with competition and tendering being tools that can be used where appropriate, rather than standard expectations. The scheme should be applied by NHS bodies (NHSE, ICS NHS, NHS TRUSTS and FT) and local authorities when making decisions about who provides health services. The system defines certain key criteria that decision-makers must take into account when organising services, as well as requirements for transparency and control of decisions. More details on pages 30-31. This Appendix to the Guidelines for Clinical Commissioning Groups in the Preparation of Integrated Care Committee Constituencies contains the model constitution for Integrated Care Committees. It has been prepared to ensure that the constitutions of integrated care committees comply with legal and policy requirements, including appropriate local flexibility. ICS will be nationally accountable to NHS England through their KBs for NHS spending and performance.
They are expected to break even and meet national performance requirements and targets. In addition to these national responsibilities, IBS also has the potential to promote various forms of surveillance to foster local improvement in care. ICS are partnerships in which local organizations provide collective leadership and work to develop a sense of mutual responsibility for the use of resources and results. This can take the form of peer challenges and partner support within an ICS based on local performance and outcome data. To truly understand if their work is making a difference, ISS needs to leverage the knowledge of local communities such as patients, service users and families. As we have argued in previous papers, the best way to understand whether integration is working is through the eyes of the people who use the services. The Health and Care Act 2022 made significant structural changes to the commissioning of the NHS. The CCGs were abolished, their functions and many of their employees transferred to the CIOs. The ICBs have also taken on some of the tasks of commissioning NHS England, including the commissioning of primary health care and some specialist services (with an additional delegation plan over time), giving local systems greater say in how budgets for these services are used in their region. These changes build on commissioning changes that have been underway for several years. Prior to their abolition, many CCGs had worked more closely together at the system level through joint management structures or formal mergers, and the number of CCGs had decreased significantly. At the same time, many CCGs have worked more closely with local councils at local level to coordinate the commissioning of the NHS and local authorities, and some larger CCGs have organised some of their functions via system-wide footprinting and other functions around local footprints.
The legislation also amended procurement and competition requirements by removing the requirement for a mandatory new competitive bidding (supported by a new supplier selection regime to be implemented by December 2022). It`s all part of a transition to strategic commissioning and a more collaborative approach to service planning and improvement. This means that the role of Commissioners, rather than focusing on procurement and contract management, is to work closely with key partners across the system (including suppliers) to understand public needs, identify key priorities, and design, plan and allocate resources to services to meet those needs. These draft guidelines address the expected governance requirements for integrated care boards, as outlined in the proposed Health and Care Act and the Integrated Systems of Care Design Framework. ICS-NHS organisations need to adequately equip quality governance arrangements, including the management of system quality groups (formerly quality monitoring groups) and ensure that clinical and nursing professionals are able to participate in quality monitoring and improvement. Operational support is also provided by NHSEI`s regional and national teams, in line with the National Quality Council`s guidelines of the updated Joint Quality Commitment and Position Paper. These key documents set out the core principles and consistent operational requirements for quality monitoring that ICS should incorporate during the transition period (2021-2022) and beyond. These guidelines for clinical commissioning groups to prepare constitutions for integrated care committees are published by NHS England and NHS Improvement after approval of the Health and Care Act 2022. It sets out the relevant requirements of this Act and NHS England policy, in line with the preparatory guidelines first published in the summer of 2021 and refined when the Act was passed and developed with partners and integrated care committees. ICS standards and requirements for digital technology and data focus on the What Good Looks Like framework, which identifies seven success metrics for digital and data transformation. The framework will be published in the first quarter of 2021-2022. There is a balance between consistent requirements and the flexibility to design working methods that best reflect local realities, and this document aims to achieve both.
It describes the `core agreements` that the NHS expects from each system, and those that local partners are expected to define in their local context. based on their scope, geography, population health needs, and maturity of system arrangements. In contrast to previous attempts at NHS reform, national NHS bodies have taken a relatively permissive approach that helps guide the design and implementation of ICS locally within a broad national framework. As a result, there are significant differences in the size of the systems and the arrangements they take, as well as large differences in the maturity of partnership cooperation. The legal requirements for ICS have created greater consistency in their governance arrangements and responsibilities, but still leave systems considerable flexibility to define their own arrangements. This means that much remains to be seen how reforms will be implemented on the ground. Part of the Oundle area, formerly part of the Cambridgeshire and Peterborough CCG, has been transferred to the Northamptonshire CCG.