What is an Integrated Care System?
The Integrated Care System brings together a range of partners to take collective responsibility for planning health and social care services, improving health and well-being and reducing health inequalities in Northern Ireland.
Health and social care professionals, working with local councils, the community and voluntary sectors, patients, carers and service users, will plan and deliver health and social care services based on the needs of the local population.
The Integrated Care System NI (ICS NI) aims to improve the health and well-being of the people of Northern Ireland. To enable our population to live long, healthy, active lives the ICS NI will:
- Plan and deliver services based on population need.
- Deliver care within the community as far as possible, when it is required and appropriate, avoiding unnecessary visits to hospital.
- Help people to keep well in the first place with information, education and support to maintain their own health and well-being and to keep fit and well.
- Support and empower staff to deliver safe and effective services and develop their skills and expertise.
- Improve efficiency and optimise capacity, making the best use of available resources and support sustainability of services and the wider system.
Why do we need an Integrated Care System?
Our health and well-being are affected by many things, beyond the care we receive – the homes and communities we live in, our opportunities for education and employment, the conditions we are exposed to, or the choices we make.
Growing pressures on our Health and Social Care (HSC) system were increased by the Coronavirus pandemic. Demand for our services has never been greater. Our focus for the future must therefore be on reducing that demand by keeping people well in the first instance. When that is not possible timely, co-ordinated care will be provided in the most suitable setting. To do this we need to look at the whole picture and not just at what care and services we deliver in hospital settings.
There are many health inequalities in NI. These, together with a growing and ageing population with increased risk of developing multiple health conditions, mean the case for reform and transformation has never been stronger. The need for change has been clearly laid out in Systems, Not Structures (DoH, 2016) and Health and Wellbeing 2026: Delivering Together (DoH, 2017). Responding to this need, we are bringing a number of organisations together to work collaboratively to better meet the needs of people in NI.
What difference will the ICS NI make?
People often receive fragmented care from a patchwork of health and social care services that are not effectively co-ordinated around their needs. This can have a negative impact on the quality and experience of their care. We want to develop a system which helps people better manage their health and well-being and stay healthier for longer. We also want to make sure that when people do need care, that it is provided in a timely way and in the right place.
As the new commissioning framework for NI the ICS NI describes one system with distinct levels. Across NI new Area Integrated Partnership Boards (AIPBs) will use local knowledge to plan integrated and continuous health and social care services for local communities. Where necessary, highly specialised services will be planned and delivered on a region-wide basis.
What are Area Integrated Partnership Boards?
In line with the vision set out in Delivering Together local areas will be given responsibility for planning local services based on need. Area Integrated Partnership Boards will have responsibility for planning local services. Coterminous with our Health and Social Care Trust geographical areas AIPBs will identify the needs of their population, agree the key priority areas based on need, and develop plans to meet that need. Only those services that require a regional perspective will be planned regionally.
AIPBs will be made up of key stakeholders from across the HSC system. They will also include representation from Community Planning, the Voluntary and Community sectors and service users and carers. To prioritise and plan effectively AIPBs will:
- be provided with information on existing local services.
- look at what is being achieved for the funding that is invested.
- collectively assess that against the population need.
- determine if there is a better way to achieve improved outcomes.
Regional services will be commissioned through the Strategic Planning and Performance Group (SPPG) which will plan services based on the same underlying principles.
What makes ICS NI different to previous HSC planning models?
In developing this new commissioning framework we want to ensure that it is not overly complex. The difference with the implementation of ICS NI is that this change is about culture rather than structures. Our structures will not change significantly and you may recognise characteristics of earlier planning models. At the heart of this change is the creation of a culture focused on improving how we work as a system and how we commission services better towards outcomes. To this end we must build trust and nurture genuine integration which make a positive difference to our partners and providers, users of our services and the citizens of NI.
The Integrated Care System will provide us with the vehicle to work differently, across sectors and across the HSC, to provide an improved experience for those we care for, our staff and the wider population. Importantly, it is the vehicle that will allow us improve health and well-being outcomes and reduce health inequalities of our population.