What the new integrated care model means for specialised services

In July this year, the Government passed the long-awaited Health and Care Act 2022. A major part of the legislation was designed to drive integration of local services with the aim of enabling areas to adopt a preventative approach that focuses on population health.

After many years of movement in this direction, 42 Integrated Care Systems (ICSs) were formalised and tasked with bringing local health services together to provide more joined up care. Unlike unpopular health system reforms of the past, the broad consensus is that this reform is both important and progressive. Indeed, this was a reform that NHS England itself had called for.

However, major changes to specialised commissioning have raised concerns. In particular, patient groups have many questions around the impact these changes may have on the day-to-day care of people living with complex conditions.

Previously, NHS England commissioned many specialised services. As a result of the Act, the majority will now be commissioned locally by Integrated Care Boards (ICBs).

But complex conditions need complex care. The move to local commissioning is risky, mainly because a population management approach is not suitable for rare and complex conditions and commissioner expertise may be lost in the transfer.

Against this backdrop, WA Communications has been working with Muscular Dystrophy UK, the charity for the 110,000 people living with muscle-wasting conditions in the UK to understand the situation better.

Together, we’ve been exploring how ICSs should approach their new commissioning responsibilities to ensure people with muscle-wasting conditions receive best-practice care from 2023.

It’s vital that ICSs get this right, so that patients with muscle-wasting conditions experience at least a maintenance, or at best an improvement, in their care.

Our work culminated in a report, based on insights gained through workshops with clinicians and an APPG on Muscular Dystrophy meeting. The report can be accessed here. We identified three key areas that ICSs need to focus on:

1. Building understanding: Inevitably, ICS commissioners and community clinicians may be less familiar with muscle-wasting conditions than specialist commissioners. However, it is fundamental to the commissioning and provision of good care that there is appropriate understanding of the condition and the level of care required. Finding ways to rapidly boost knowledge must be a priority.
2. Holistic approach: There is a real opportunity for ICSs to improve care due to their in-built, joined-up approach. This means moving away from a sole focus on medical care to one that includes social care, education, physical activity, all of which takes place closer to home.
3. Data: High quality and regularly updated data are vital for oversight of the quality of care, service planning and improvements. NHS England could support effective local commissioning through the creation of a data dashboard across ICS regions. This could outline key datasets for muscle-wasting conditions, such as condition prevalence, time and route to diagnosis, mortality, admissions and treatment.

You can download the full report here:

The new integrated care model and muscle-wasting conditions: How Integrated Care Systems can implement best-practice

Change of this nature is never easy, especially in a period of financial constraint and workforce pressures. However, focusing on the opportunities for better, more joint-up care – ideally backed up by robust data – could deliver important outcomes for people with muscle wasting conditions. Because ensuring the best possible integrated care for patients with all complex conditions can only be achieved through collaboration, communication and consistency.

We have been proud to support Muscular Dystrophy UK in this important pro bono project. You can read the full Muscular Dystrophy UK report on The new integrated care model and muscle-wasting conditions: How Integrated Care Systems can implement best practice here. If you are interested in learning more about how we can help you, please get in touch with carolinegordon@wacomms.co.uk