Frequently asked questions and answers about the Integrated Care System NI.
Click on the questions below to view the answers.
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What is the Integrated System for Northern Ireland (ICS NI)?
ICS NI is the new framework for planning health and social care services in Northern Ireland which looks to improve the health and well-being of our population by:
- placing a focus on people keeping well in the first instance, providing timely, co-ordinated care when they are not, and supporting people to self-care when appropriate; and
- ensuring we are maximising the resource we have available to deliver the best outcomes for our population, optimising our effectiveness and efficiency and reducing duplication.
ICS NI signals a move away from the complex, transactional process of the past to one that is focused on collaboration, outcomes and person-centred care.
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What is the aim of ICS NI?
The overarching vision of ICS NI is that of one system working in an integrated and coordinated way to plan and deliver health and care services to improve the health and wellbeing of our population and address demand through two key objectives:
- The first is to improve how we integrate and collaborate within health and social care to ensure we are planning, managing, and delivering health and care to best effect. This will be achieved through working in partnership to remove duplication, address unwarranted variation, and develop integrated pathways that not only make more efficient use of our resource but provide a better outcome and experience for people who use our services.
- The second is to improve how we work both locally and regionally with others to focus in on prevention, early intervention and community health and wellbeing. We are creating partnerships at both levels that will seek to improve population outcomes through more effective use of the collective assets available in local areas and across NI.
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What is being put in place to achieve these aims?
The ICS NI is a joined-up planning system for health and social care in NI, with three core aspects:
- Planning and managing integrated care and services across the system, informed by local and regional collaboration, will be the role of the Strategic Planning and Performance Group (SPPG) supported by the Public Health Agency (PHA)
- Working locally in partnership beyond the HSC, to identify local needs, agree priorities and identify what cross-sector collective action should be taken to effect change with a focus on prevention, early intervention and community health and wellbeing. To support this, five Area Integrated Partnership Boards (AIPBs) will be established.
- Working regionally in partnership to support the work of the AIPBs, identify areas for regional collaboration and support shared learning. To support this, a Regional ICS Partnership Forum will be established.
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When will ICS NI launch?
Work is currently underway to stand up ICS NI in shadow form. This will include the establishment of shadow AIPBs on a phased approach and the subsequent establishment of the Regional ICS Partnership Forum to align with this roll-out. Shadow AIPBs will be put in place on a phased basis in the latter half of 2024.
Changes to improve planning arrangements in the SPPG and PHA are already underway to coincide with the ICS NI launch.
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What is meant by shadow?
There is duty on the Department to establish Area Integrated Partnership Boards in statute.
However, before doing so, it is important to take account of lessons learned from the past and engagement with other jurisdictions who have already commenced their work on a system of integrated care. Therefore, a period of shadow running of the ICS model will provide essential learning before any legislation is introduced.
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Who has been involved in the development of ICS NI?
Stakeholders from across health and social care, voluntary and community sectors, local government and service users and carers have been involved and made invaluable contributions in the development ICS NI.
Engagement and communication will continue to be central as we progress through implementation.
An external eZine, ICS Connect, has been developed with more details on ICS NI available online.
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What sets out the strategic direction?
A Strategic Outcomes Framework (SOF) has been developed which will provide the strategic direction to the whole system. It reflects Ministerial and Departmental priorities derived from the understanding of people’s health and wellbeing needs and priorities.
These strategic outcomes will reflect the vision of health and wellbeing that we want to achieve through broad, aspirational statements. They will be the driver for the planning, management, and delivery of services at all levels of the system.
Key indicators, or measurements, have also been developed to support us to monitor progress and impact against each of the strategic outcomes. They will help to provide an insight on how well the system is doing.
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How will the SOF link with the Programme for Government?
The outcomes produced for the SOF will be fully aligned to the overarching Programme for Government (PfG). Each strategic outcome will link to one or many of the PfG outcomes, and any progress towards them will feed into impacting the PfG outcomes.
The draft 2021-2026 Programme for Government Outcomes Framework was the subject of a public consultation in the spring of 2021, and its draft outcomes served as the basis upon which the SOF was produced and aligned.
Findings from this consultation have not yet been published and there may be some changes to the draft outcomes. Provisions have been made to review and adapt the SOF accordingly, if and when required.
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How was the SOF produced?
The design and development of the SOF requires the understanding of people’s health and wellbeing needs and priorities. As a starting point, official data and statistics were used to draw a profile of the Northern Ireland population.
This informed a wide series of engagement events to gather views and insight from the general public about what matters to them in terms of health and wellbeing to support the development of the population-level strategic outcomes for Northern Ireland.
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How will health and social care services be planned within ICS NI?
Our health and social care services are typically organised into different groupings such as primary, secondary and community care.
Planning and managing services along individual groupings makes it difficult to plan and deliver integrated care and can lead to duplication, inefficiency and people experiencing fragmented services.
It is essential that when we plan services we do so across the entire spectrum of health and social care applying a population health approach that is centred around the needs of the population and not based on individual silos.
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How will this be done?
Responsibility for the planning and management of health and social care services will reside with the Strategic Planning and Performance Group (SPPG) in partnership with the Public Health Agency (PHA).
We are establishing multi-disciplinary planning teams which will be co-chaired by SPPG and PHA and will cover the spectrum of health and social care from primary care, secondary care and community care. They will adopt an evidence-based, outcomes-focused approach, inclusive of the input from across the system, networks, communities, and service users, in line with the underlying principle of integration.
Working in partnership will enable the identification of duplication, best practice, inefficiencies or indeed where this is a more appropriate way or indeed organisation or sector to deliver a service. Importantly it allows for the design and development of integrated pathways which will provide a better service to the user.
Their aim will be to improve the delivery of high quality and safe HSC services, reduce inequalities, and improve health and wellbeing in Northern Ireland.
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What is an Area Integrated Partnership Board (AIPB)?
In line with our aim to embed a population health approach to planning of health and social care, AIPBs will provide the vehicle to work with other stakeholders at a local geography to focus in on community health and well-being, proactively take action to keep people well in the first place and supporting them to self-care and where this is not possible, enabling intervention at the earliest possible point.
There will be five AIPBs established across the region. These will mirror the geographical boundaries of our existing Health and Social Care Trusts.
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How will AIPBs work?
AIPBs will be guided by the strategic priorities and the Regional ICS Partnership Forum. AIPBs will identify the needs of their local population through a population health needs assessment, as well as from local input and intelligence gathered through engagement and involvement of their local populations.
With a focus on prevention, early intervention and community wellbeing, they will look at what is currently being delivered with the assets and resources available across the relevant sectors in their area. They will collectively assess that against population need and determine where making changes can achieve improved health outcomes.
AIPBs will develop plans detailing what collective actions they have agreed to take forward and will work to support each other in the delivery against these plans in line with their collective responsibility.
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Who will be involved in an AIPB?
The membership of the each AIPB will include representation from across organisations and sectors which have a role in the health and social wellbeing of the population of Northern Ireland. This includes HSC Trusts and primary care, local councils, the voluntary and community sector, and service users and carers.
AIPBs are free to draw on the knowledge, experience and expertise of a broad range of clinicians, professionals, networks and alliances, organisations and other bodies when undertaking their work. They will engage and include individuals and groups as required, drawing on the existing infrastructure in their area to do this.
Each AIPB will also have Strategic Partners from SPPG and PHA who, whilst not members, will support the work of the AIPB. The Partners will have expertise in planning care and services and population health approaches. This will be critical in providing the mechanism for AIPBs to inform the wider planning of health and social care services.
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Who does an AIPB report to?
AIPBs will submit a plan for their local population to the Department and report on progress against the plan.
Importantly, it is for members to collectively agree their plan. Individual members will seek and secure approvals for specific actions from their respective organisations where this is necessary and appropriate, but plans will not need Departmental approval, giving the AIPBs autonomy to put change into effect.
AIPB members will work to support each other in the delivery against the plan and in line with their collective responsibility, with each member holding themselves and the other partners accountable for the actions they have collectively agreed to deliver through their plan.
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How will shadow AIPB members be selected?
Members will be identified via nomination and selection process. All members except Service User, Carer, Voluntary and Community Sector and local Government representative members will be identified by nomination.
The Service User and Carer selection process, via an Expression of Interest, closed in February 2024.
An independent organisation conducted the Voluntary and Community Sector nomination process, and this closed in March 2024.
The local Government representative selection process, via an Expression of Interest, launched on 29 July 2024 and closes on 6 September 2024.
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Have the AIPBs been tested?
A Test Area Integrated Partnership Board (AIPB) in the Southern Area was established in May 2023 to trial a key aspect of the ICS NI model in practice.
This provided the opportunity to:
- test how this key component of the ICS NI model would work practically,
- understand the needs of the organisations and sectors involved,
- understand how best to establish strong foundations to enable integrated working and provide the best environment to help the system develop and mature, and
- identify any aspects that may been overlooked or underestimated.
It also provided the opportunity to further refine the roles of strategic support partners and inform how both SPPG and PHA are organised to support the AIPB including the business support required to produce detailed evidence-based plans.
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Who was involved in the Test?
The membership of the Test AIPB consisted of representatives from various organisations and partnerships already in existence across the local area, including Trust colleagues, General Practitioners, Community Pharmacy, the Voluntary and Community Sectors, a service user, a carer and Council Officers from each of the three Local councils in the area.
A Regional Working Group with representation from across all organisations and sectors involved in ICS NI, was formed to oversee the Test.
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What were the findings of the Test?
The Test has been evaluated against a set of defined and agreed objectives and success criteria. A copy of the full evaluation report is available on the ICS NI webpages.
The findings from this Test have enabled us to refine the design of the AIPB and the model as a whole, and to embed any recommendations into our implementation activities that will see ICS NI stood up in shadow form in the coming months.
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What is the Regional ICS Partnership Forum?
Aligning to the core aims of maximising resource and shifting our focus to a population health approach, there is a recognised need for a mechanism at a regional level that will ensure connectivity across the five AIPBs but also provide a forum to capitalise on regional collaboration.
Whilst each AIPB will operate independently, learning from the Test AIPB supported the provision of a set of planning assumptions in order to provide guidance and clarity on key strategic areas that are considered relevant to all AIPBs.
These will be defined by the Regional Forum and will be reflective of the priorities of all members. These assumptions are not intended to be prescriptive but rather provide focus and a means of supporting the AIPBs to remain aligned to their overarching objective.
The Regional Forum will also identify areas for regional collaboration facilitating joint action to improve health and care outcomes and experiences across the population of Northern Ireland, influencing the wider determinants of health, including creating healthier environments and inclusive and sustainable economies.
Additionally, it will provide a platform for shared learning, where AIPBs can showcase best practice and learning.
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Who will be involved in the Regional ICS Partnership Forum?
The membership of the Regional ICS Partnership Forum is still being finalised, but it is anticipated that it will include representation from each AIPB, the Department of Health, Public Health Agency, NI Ambulance Service, Councils and the Voluntary and Community sectors.