What is an Integrated Care System (ICS)?

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Big changes are taking place  across the health and care system.
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What does this mean for the  organisations that make up the NHS?
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How will they collaborate with other parts of the system?
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And what will these changes mean for you and me?
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When the NHS was set up
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it focused on treating single conditions or illnesses.
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Since then, our health and care needs have changed;
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more of us are living longer
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and many have multiple conditions
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that require regular, ongoing care.
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However, this hasn’t been reflected in the NHS’s structure,
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a patchwork of organisations
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that often work independently from one another.
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Navigating this can be confusing
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and can have a negative impact on our experience of care.
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So, for some years now,
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health and care staff and leaders,
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have been working to bring organisations closer together
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to better meet our needs by working in a joined-up way.
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Primary and secondary care,
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social care, mental health
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and community health services
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have been seeking to partner with each other
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in different ways.
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At a very local level,
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GP surgeries have been coming together
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to form primary care networks,
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groups of practices working together
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across areas called ‘neighbourhoods’.
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By sharing resources
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and working closely together
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with other local people and services,
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they can provide a wider range of services
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than a single GP surgery.
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Health and care organisations
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have also been working together
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across larger areas called ‘places’
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– often covering the same area as a local authority –
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where large parts of the NHS budget are spent.
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Here, local government, charities,
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residents and NHS partners
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can work together to understand and meet local health needs.
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But previous laws
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have prevented services becoming even more joined-up.
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The 2022 Health and Care Act aims to change this
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and make it easier for organisations to work together.
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But what do these changes look like?
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Organisations are now coming together
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across even larger areas
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to form integrated care systems,
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partnerships of health and care organisations
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that plan and pay for health and care services.
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There are around 40 integrated care systems across England
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and although they’ve existed for some time,
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the Health and Care Act gives them legal status,
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as well as new powers and responsibilities.
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Integrated care systems are made up of two parts:
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integrated care boards
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and integrated care partnerships.
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Integrated care boards
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decide how the NHS budget for their area is spent
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and develop a plan to improve people’s health,
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deliver higher-quality care
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and better value for money.
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Integrated care partnerships
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bring the NHS together with other key partners,
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like local authorities,
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to develop a strategy
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to enable the integrated care system
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to improve health and wellbeing in its area.
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NHS trusts are also coming together
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to form provider collaboratives,
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new partnerships that can bring together providers
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such as hospitals, mental health services and community services.
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So, how are these new structures funded?
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Integrated care systems
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get most of their money from NHS England,
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which is the national body for the NHS in England,
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and sets the operational priorities for the health system.
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It’s responsible for the health  services you and I access day to day,
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which are inspected and regulated
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by the independent Care Quality Commission.
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The Department of Health and Social Care
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sets out what the NHS is expected to deliver
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for the money it gets from the government
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– which comes from our taxes.
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It also holds budgets for some of the other areas
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that have an impact on our wellbeing, like public health.
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Throughout these new structures,
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local authorities play a key role;
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they receive money locally
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and from national government,
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which goes towards funding a range of services
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that support our wellbeing and prevent ill health.
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So, what does this all mean in practice?
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The Health and Care Act has  put in place a legal framework,
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that enables services to  work more closely together,
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so it’s easier for you and I to receive the care we need,
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when and where we need it.
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For these changes to succeed,
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staff and local leaders will have to  work with one another differently,
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alongside key partners in local government,
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the voluntary sector, and communities themselves.
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Of course, services face other challenges,
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like workforce shortages, growing waiting lists
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and the impact of the Covid-19 pandemic.
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While the new structures won’t fix all these issues,
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by enabling services to work more closely together
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and join up services for patients,
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it’s hoped that the health and care system
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will be better able to meet
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our changing health and care needs in the future.
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Find out more about how the health and care  system is changing at: www.kingsfund.org.uk/explain