In the midst of the COVID-19 response, an important vote has taken place which will help to shape how the health and care system will work over the coming months. Colleagues in General Practice have voted to support the formation of a single Strategic Commissioning Organisation across Staffordshire and Stoke-on-Trent. After months of discussions and a week of voting, the vote closed last night. I would like to congratulate all colleagues that have worked or contributed to this; and to our GP colleagues for helping to shape the future direction of travel.

This is a significant milestone in the development of an Integrated Care System for our area. However, the vote is by no means the end in itself. The most important aspect is about how we genuinely commit to working across sectors and across boundaries to drive our approach to integrated care. Ultimately, we have to be able to demonstrate better outcomes for the local population that we serve, and we have to have an unremitting focus on tackling the wider determinants of health across our local area.  To do this well, we need the input from strategic commissioners to help shape our priorities and focus our work around improving outcomes. The positive outcome of the vote is a step along that evolution.

Of course, there is still a process that needs to be followed, including listening to the views of stakeholders and public to understand if there are any mitigations that need to be put in place if a single Strategic Commissioning Organisation is formed. At some point, the Governing Body in common for the CCGs must submit a formal application to NHS England and NHS Improvement, following the membership vote. This formal process shouldn’t detract though from the work that we can continue to progress around health inequalities and improving outcomes.

As I stated at the outset, this is a really positive step forward though, and one that we will want to build on. It is an important step in our application to NHS England and NHS Improvement to formalise the Integrated Care System for Staffordshire and Stoke-on-Trent. We are still waiting for clarity on what any new Health and Social Care Act might look like, but whatever the future form takes, it is clear that a single strategic commissioning function for each ICS geography is an essential element.

We are making good progress across a number of areas and I am keen that we now look to move at pace on the things that are important to local people and to our clinical and professional leadership. We know that we have more work to do around the governance aspects, but the real work needs to be about delivering genuinely integrated care, about partnership and about working with local communities. The NHS and Local Government will be central to building an approach that at its core is about helping local people to ‘an education, a job, a home and a friend’. This will really get us into the wider health inequalities issues that matter to local people.

So, what difference will this make?

This has been talked about for a long time in health and care – both nationally and locally. The NHS Long Term Plan (released in 2019) made a clear commitment that Sustainability and Transformation Partnerships should evolve into Integrated Care Systems by April 2021.

Health, care and voluntary partners have all been discussing how we make this a reality over the past few months.

GPs, as the membership of CCGs, realised that we have a collective opportunity to shape a future structure that meets local needs and I am grateful to them for their support in moving this agenda forwards at this point in time. We need to make the most of this opportunity, build on the improved partnership working during COVID-19 and create a truly integrated system.

Important priorities, including digital innovation, tackling inequalities, a sustainable financial strategy and population health management for a clear purpose need to be central to everything that we do as a partnership and a strategic commissioner will help with this.

How do we continue to prioritise local decisions?

We recognise that we have a varied and diverse area and that we cannot do everything centrally – nor should we! In fact, today’s decision to create a single strategic commissioner is more about how we devolve power and resource down to our local place partnerships. It is much more about how we support our providers to collaborate and work differently in order to meet the needs of the local population. Local providers are best placed to help tackle some of the inefficiencies and unwarranted variation in outcomes that exist in our system and in being innovative about how care is delivered. This is a clear ask for them to now step into that space and really demonstrate the progress that is possible. The majority of our focus and work will be happening at a neighbourhood level within our Integrated Care Partnerships and Primary Care Networks. By delegating more responsibility and funding to this local (place-based) level, we can ensure our services are informed by local needs rather than a one-size-fits-all.

This means creating local networks, with GPs, providers, local authorities and the voluntary sector all having a greater say in health and care at a grassroots level. We have to stop just talking about this now though, and we need to see faster progress.

Importantly, patient care and clinical treatment paths should be designed by those who understand patient needs best. This is the theory, and our job before April and in the first year of our ICS is to turn this into a reality. We will need everyone to play their part with this, if we are to go beyond a new name and actually make a difference for our staff and patients.

This is one of the hardest 12 months our the country has ever faced, and rightly so our staff and clinicians are focused on saving lives. However, out of this pandemic we will be a stronger system and have built the foundations that mean we can tackle some of the longstanding issues we have faced. As ever thank you to you, your Boards, your staff and your partners for the amazing work that you continue to do every single day. It is testament to you all in terms of the strength of the local COVID-19 response and how you have collectively overcome many of the challenges that you have all faced.

Prem Singh

Chair of the Integrated Care System (shadow)