Healthwatch Barnet organised a public event to enable Barnet residents to hear about the development of the forthcoming Integrated Care System from those responsible for implementing it. Thank you to everyone who attended and for your questions, and thanks too to our panel: Richard Dale, Executive Director of Transition, North Central London CCG; Dr Nick Dattani, GP Partner & Barnet Clinical Lead, North Central London CCG; and Colette Wood, Director of Integration for Barnet, North Central London CCG.
What is the Integrated Care System? How will it work?
The Integrated Care System is intended to remove traditional divisions between hospitals and family doctors, between physical and mental health, and between NHS and council services. Richard explained how that will affect residents of North Central London i.e. Barnet, Camden, Enfield, Haringey and Islington.
Whereas in the past services, e.g. hospitals were in competition for funds, the legislation currently going through the House of Commons puts the emphasis instead on collaboration. Hospitals, GPs and community services will all be able to work together much more closely as a result.
Richard described how in effect this started during the pandemic with hospitals sharing resources and beds and moving staff around to where they were most needed; critical care teams were working together every day to ensure patients were able to access the best care. The pandemic also led to greater collaboration in community care and he used the vaccine delivery as a great example of this.
The new system will also see work done to join up health and care services so that patient records can be accessed as necessary, avoiding the current situation where patients often have to repeat their stories at each appointment.
At borough level, the ICS will bring together partners who haven’t always been round the same table – the voluntary sector, community services, acute hospital care and GPs.
Colette used the example of the support Barnet gave to care homes during the pandemic as further evidence of the benefit of closer co-operation. Barnet has 84 care homes, more than any other London borough, and during the pandemic, a multi-disciplinary team including all 52 of the borough’s GP surgeries was formed to offer support around care and infection control. Digital enablers made an invaluable contribution too (a sign of things to come) enabling ‘virtual ward rounds’ to take place in care homes.
She also highlighted the vaccine programme as proof of how powerful it can be to integrate services, praising GPs, community providers, Age UK Barnet, the Barnet COVID Health Champions and Groundwork for their joint work.
Richard emphasised too that what matters to residents will be central to the new system, patient engagement forums and participation groups contributing at every stage.
Dr Nick Dattani expressed his excitement about the new opportunities for GPs, particularly around patient records. “When patients come to see me, I will be able to access the hospital system immediately without the need to wait for a letter from their consultant.” The system will be more streamlined, with faster communication and less likelihood of duplication. Patients won’t notice any change to their interactions with health services after 1 April, when the system comes into effect, but they will notice the improved quality of care and improved outcomes, he explained.
The panel then answered questions from our audience about the ICS.
Q: How will health services differ from social care services in the future?
A: The ICS allows for them to be more joined-up and to integrate services where it improves care for residents. A ‘single team’ approach means delivery of ‘whole person’ treatment.
Q: How do the forthcoming changes differ from previous attempts to integrate health and social care? Will they be long-term?
A: Richard said that the lived experience of responding to the pandemic has brought a new level of understanding of the importance of joining up services. The focus too will be on sustainable funding, technical changes to the system allowing for money to be used in ways it couldn’t before, with the opportunity to invest more freely in community and primary care.
“There’s the opportunity to make a real difference.”
Q: What are the milestones for the ICS?
A: The statutory organisation comes into being on 1 April 2022, but work has already been going on, getting the right people into place, investing in teams and ensuring that patient voices are heard.
Q: How will patients’ voices be heard?
A: The legislation calls for two boards: the Integrated Care Board, which will have responsibility for managing the NHS budget; and a partnership board setting the wider strategy. Barnet is recommending a third board, on equal footing with the other two, which will have on it members of the five Healthwatch and representatives from the voluntary sector repsesnting local residents.
There was a further Q&A on wider issues, including access to GPs, plans to increase capacity at A&E departments, and vaccinations for care home staff. Watch the event in full if you want to know more.