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