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The State of Integrated Care Systems: Finances
The State of Integrated Care Systems: Finances

Posts Tagged ‘Mike Bell’

What does the future of healthcare look like under a Labour Government

Last month we were delighted to host a panel session exploring how Labour’s priorities for the NHS are translating to on-the-ground action. To tackle this question, we were joined by an expert panel including David Thorne, Transformation Director of Well Up North Primary Care Network (PCN), Mike Bell, Chair of South West London Integrated Care Board (ICB), and Ellen Rule, Deputy CEO of Gloucestershire ICB.

Guided by WA’s Head of Health, Dean Sowman, the discussion dived into the key challenges and opportunities in shaping the NHS 10-Year Plan, offering a thought-provoking vision for the road ahead.

Since the Labour Government took office, healthcare has been placed firmly in the spotlight. Health Secretary Wes Streeting’s description of the NHS as ‘broken’ and in need of repair has ignited a bold wave of review and reform. From the influential Lord Darzi review and the subsequent three transformative shifts in healthcare – from hospitals to community care, analogue to digital, and treatment to prevention – to the recent launch of ‘name and praise’ league tables and the upcoming NHS 10-Year Plan, the stage is set for significant change.

As decision-making shifts from NHS England to the Department of Health and Social Care, the UK is entering a new era in healthcare. In the short term, the focus is on decentralisation with ICBs gaining more autonomy and greater control over budgets, sparking tensions between national oversight and local autonomy.

Below we outline five key insights from the panel discussion, shining a light on what these changes could mean for the future of healthcare.

  1. A Budget Focused on Stability, not Growth

The latest budget promises no return to austerity, but still falls short of the investment needed to rebuild public services that have been significantly reduced and strained. While the NHS welcomes a projected funding growth of 3.6–3.7% over the next two years, the system continues to grapple with the lingering consequences of underfunding.

On a positive note, this funding boost provides an opportunity to invest in NHS digital infrastructure, a vital step towards stabilising operations and creating a foundation for transformative change.

Productivity remains a key challenge, with NHS staff expected to improve efficiency despite limited increases in resources. The legacy of austerity continues to hold back progress, while the funds allocated for the elective recovery programme have fallen short of delivering anticipated improvements.

Panellists described the budget as a ‘stand still’ measure – enough to maintain current services but offering little scope for meaningful progress. They concluded that while the resolution of GP pay disputes is a step forward, critical issues such as GP contracts and National Insurance rises  remain unresolved.

  1. Building the Digital Foundation for NHS Innovation

Before AI can revolutionise healthcare, the NHS must first build a solid digital foundation by tackling basic issues, such as interoperability and shared patient records. Currently, fundamental issues concerning digital skills and infrastructure are apparent, for example healthcare professionals requiring keyboard skills training or multiple landlines needing to be installed.

The shift from analogue to digital is essential, but it’s about more than just adopting new technology. The NHS still lacks an integrated system of care and addressing the fragmentation and “tribalism” between NHS departments is critical to achieving any real progress.

To unlock the potential of AI, ICBs must first strengthen their collaborative efforts, with Chairpersons meeting regularly to align on strategy. AI could help triage patients more efficiently, ease pressure on ambulance services, and optimise primary care across regions.

Meanwhile, investing in ambient technology could boost GP productivity by up to 20%. By automating notetaking and coding during consultations, GPs could see a reduction in administrative burden andincreased capacity, while also preventing burnout. In turn, this could lead the way to a more sustainable workforce, with less bureaucracy, and ultimately improved patient care.

  1. Rethinking Prevention and Productivity

Healthcare transformation should extend beyond focusing solely on economic metrics, incorporating prevention models that prioritise social value and patient outcomes.

Traditionally focused on hospitals and waiting times, the NHS must shift its focus to prevention and address the root causes of hospitalisations. However, the current emphasis on productivity often overlooks acuity – the complexity of modern patients – and fails to address the underlying causes of ill health.

A major challenge is the workforce imbalance. The NHS Long Term Workforce Plan calls for a 40% increase in hospital staff, but only a 5% increase in GPs, this disparity is unsustainable under Labour’s three healthcare reforms. To support the shift from hospital to community care, a fundamental reallocation of both funding and workforce planning is urgently needed.

PCNs are already preparing for this shift by planning further investment into preventative and primary care services and reducing investment in acute hospital care over the coming years. This means redirecting resources from hospitals to community care and integrating services across both sectors within single NHS trusts. By doing so, hospital admissions will be reduced and NHS pressures alleviated, while the focus will shift from output-driven metrics to quality patient care.

  1. Integrating Responsibility: ICBs and the Future of Resource Management

ICBs already have significant autonomy, but the challenge lies in making collective responsibility for resources a reality and ensuring accountability. While some ICBs are integrating services effectively, there is a need for stability during this transformation period, with limited capacity to test new ways of working.

ICBs are already shifting their resources to integrate services at the neighbourhood level, which is key to managing the hospital-to-community shift within existing budgets. Meanwhile, PCN’s have the potential to better manage vulnerable patients through enhanced GP roles and personalised care plans, reducing pressures on ambulance services and hospital waiting lists.

The partnership model in general practice is crucial, and more local integration is vital to managing complex patient needs. There is also an opportunity to empower NHS trust providers to act as direct commissioners, easing the burden on ICBs and facilitating smoother transitions from hospital to community care.

  1. The Opportunity of Specialised Commissioning Delegation

To truly transform healthcare, specialist care must be viewed within the context of the entire patient pathway leading into specialised services, which will ensure a more integrated healthcare system. This requires stronger collaboration between neighbouring ICBs to ensure seamless care.

As ICBs review specialised commissioning budgets, there is an opportunity to better integrate local authority and public health services. Since a single ICB’s footprint is too small for effective delegation, a pathway approach is essential.

The focus must be shifted from costly end-of-pathway interventions to prioritising the full patient journey, and shifting care from acute settings into community and primary care.

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Five key takeaways: Engaging with ICS priorities panel session

WA was delighted to host a panel session with Dr Layla McCay, Director of Policy and NHS Confederation and Mike Bell, Chair of NHS South West London integrated care board (ICB) and WA Health Senior Adviser.  

At the session, WA’s Head of Health, Dean Sowman, explored Layla and Mike’s perspectives on how the life sciences industry can meaningfully engage with, and play a role in delivering integrated care systems (ICS) priorities. 

In light of a 30% cut to operating budgets and industrial action absorbing the bandwidth of executive teams, ICSs are currently heavily focused on short-term operational priorities. We have outlined five key factors to engage effectively against this backdrop:   

1. ICSs are delaying some action until the general election 

Whilst both the Labour and Conservative parties have communicated support and optimism for ICSs, the reality is that political uncertainty and operational pressures mean that many ICBs have little bandwidth to implement their ICB led five-year joint forward plan.  

Instead, ICSs are increasingly deferring important decisions until there is a stable administration which can ensure the preservation of essential funding and objectives. The overarching concern is that the exact vision of ICS working to respond to local population needs will be overshadowed by national pressures.    

Whilst this is a considerable challenge, the take home message for organisations looking to engage is the importance of timing the hope is that following the winter period, which is a particularly politically sensitive time, ICSs will have greater bandwidth to begin to implement their strategies.  

2. There’s no shortcut to engaging with all ICSs, and no one-size fits all approach 

When looking to secure policy changes, there is currently no shortcut to speaking to all 42 ICSs. We are starting to see some ICSs coalescing or developing strategic multi-ICB structures where some ICBs lead on certain workstreams on behalf of others. This trend is likely to become more commonplace – so engagement may become more streamlined in the future.  

For now, the best route to engage with multiple ICSs comes through existing forums, including NHS Confederation’s ICS network and NHSE’s Academic Health Science Networks (AHSN) 

3. Medicines optimisation and management is a priority with positive examples needed  

One key barrier to ensuring medicines optimisation is that current financial models are created to show benefits to local service providers – some of which are not covered by ICS budgets. There needs to be an overhaul of where the service is delivered, where the money flows and where the savings are realised. While there is clarity on this being a problem – at present there is no solution.  

NHS Confederation would welcome examples of impactful collaborations between ICSs and industry as there is currently a shortfall of tangible examples.  

4. New evidence and ideas to support the delegation of specialised commissioning are welcomed  

The delegation of specialised commissioning to ICSs remains a concern. Prescribing budgets will remain with NHS England, but services deemed ready for integration will be delivered locally. There are outstanding questions as to whether individual ICSs are equipped with the right workforce and expertise, and what multi-ICB structures could be formed.  

This is especially pertinent in the case of rare diseases. Given their low prevalence in local areas, rare diseases are unlikely to be a core focus for ICSs, as evidenced by WA’s analysis which found that just five of the ICB five-year plans featured rare diseases.  

However, there is optimism that the transfer of specialised commissioning responsibilities offers the opportunity for a reset. If done right, it could ensure the repurposing of specialised commissioning budgets across the whole pathway, challenging local systems to reduce spend on tertiary services, and instead finding new ways to act earlier.  

5. Understanding where each ICS is placing strategic emphasis is critical 

Each ICS is at a different stage of maturity and there is distinct variation in size, scale and local characteristics, meaning a one-size fits all approach to engagement will not work. As a first step, understanding where you may wish to begin engagement and how to frame this in line with local priorities is essential. 

At the end of June 2023, 40 of the 42 ICBs had published their five-year joint forward plans setting out their strategic vision to tackle the health issues faced by their local population.  

To support industry, WA has undertaken an in-depth analysis of the plans to create an interactive map showing the level of priority each ICB is placing across 27 themes. Understanding the ICBs that are prioritising your areas of interest, can support you in identifying meaningful collaborations and partnerships aligned to an ICB goals. 

About WA Communications 

WA Communications is an integrated strategic communications and public affairs consultancy. Our specialist health practice supports clients across a diverse range of diseases at the intersection of policy, government affairs and communications, to achieve their strategic objectives. 

If you would like to discuss how to best work in partnership with Integrated Care Systems, and our analysis of their key areas of focus, contact Lloyd Tingley atlloydtingley@wacomms.co.uk. 

 

 

 

 

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NHS Leader Joins WA Communications Advisory Board

We are pleased to announce the appointment of NHS leader Mike Bell to our growing advisory board. Mike Bell brings a wealth of experience and expertise in the healthcare sector, having served in various senior roles within the NHS.

Mike is currently Chair of NHS South West London Integrated Care Board and Chair of Lewisham & Greenwich NHS Trust.

With over 25 years of NHS board level experience, including more than a decade on strategic health authority boards, including as vice-chair of NHS London, Mike brings a deep understanding of the healthcare landscape to his advisory role. Previously, he served as the Chair of Croydon Health Services NHS Trust, playing a pivotal role in improving healthcare services in the Croydon area.

Our specialist health practice offers integrated services in public affairs, corporate communications, digital, research, and creative services. Current clients include life sciences companies including Sanofi, AbbVie and Roche, as well as charities and patient groups including Guide Dogs and Muscular Dystrophy UK.

Mike Bell’s appointment to the advisory board further strengthens our commitment to providing strategic counsel in the healthcare sector.

WA’s advisory board is chaired by Sir Philip Rutnam – former Permanent Secretary at the Home Office and Department of Transport, and founding Partner of Ofcom. It also draws together senior figures from the communications industry, Westminster, the media, and the health sector, including former CEO of Grayling UK Alison Clarke, and broadcaster & journalist Steve Richards.

Commenting on the appointment, Caroline Gordon, Partner and Head of WA Communications’ health team said,

“I am delighted to welcome Mike to our team. His extensive experience and strategic insight in the NHS and medtech sectors will be invaluable in delivering senior counsel to our clients in health and life sciences. WA is now even better equipped to navigate the complex and changing landscape of healthcare delivery and drive meaningful outcomes for our clients.”

Mike Bell added,

“I am delighted to be joining WA Communications at this exciting time. As a member of WA Communications’ advisory board, I look forward to using my experience from two decades in the healthcare sector to provide strategic guidance that helps clients partner effectively with the NHS.”

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