Developing integrated care: changes to NHS organisations in Lancashire and South Cumbria
Our agreed vision for Lancashire and South Cumbria, as described in our ICS strategy, is to empower and support healthy communities so that people have the best start in life and can live and age well.
We will do this by working well together, as equal partners, to put local people at the centre, join up health and care services, and address the critical challenges we face. By working together more effectively we will make a real difference to the lives of people and their families by supporting better health, improving health and care services and reducing health inequalities.
Joining up health and care is nothing new – we have been working towards this for some years, and we want to build on this excellent work. This includes further strengthening the incredible joint working we have seen throughout the COVID-19 pandemic, which has made a massive difference to the lives of local people and their families.
Changes to NHS organisations
On 1 July, NHS Lancashire and South Cumbria (our local Integrated Care Board) will be established and the eight Clinical Commissioning Groups (CCGs) in Lancashire and South Cumbria will be closed down and the functions of the CCGs will be transferred to NHS Lancashire and South Cumbria. The new organisation will be responsible for NHS spend and the day-to-day running of the NHS in Lancashire and South Cumbria.
Alongside the set-up of the new NHS organisation, Lancashire and South Cumbria Health and Care Partnership (our local Integrated Care Partnership) will operate as a statutory committee consisting of health and care partners across the region, including local authorities, voluntary, community, faith and social enterprise organisations and independent healthcare providers. The health and care partners will also be working in a more integrated way as part of the Lancashire and South Cumbria Health and Care Partnership. The individual organisations within the partnership will remain as separate bodies that will work more closely together with deeper levels of integration, for example by agreeing joint priorities and a joint health and care strategy.
These changes take place under the new Health and Care Act 2022, which amongst other things aims to tackle health inequalities and create safer, more joined-up services that will put the health and care system on a more sustainable footing.
At its heart, integrated care is designed to ensure that as a system we coordinate services and plan in a way that improves population health and reduces inequalities between different groups within our population.
There will be no changes to how local residents access NHS frontline services in Lancashire and South Cumbria as part of these changes.
The King's Fund: How does the NHS in England work and how is it changing?
Constitution and membership of NHS Lancashire and South Cumbria
NHS Lancashire and South Cumbria will be an NHS organisation working under a published constitution. Large parts of the constitutions for Integrated Care Boards have been set nationally by NHS England with certain elements for local determination. There has been extensive engagement with partners about the proposed membership of the Board in Lancashire and South Cumbria and the contents of the constitution and these have been discussed in meetings held in public.
Within the model constitution published nationally, there is a section that states who is not allowed to be a member of the board. One of the stated exclusions is anyone who could be seen as ‘undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise’. The ICB in Lancashire and South Cumbria will apply this test to all of its members.
The ICB unitary board membership has now been confirmed and is comprised of Non-Executive Members (NEMs), ICB Executive Directors (EDs) and Partner Members, who will be collectively and corporately accountable for organisational performance, ensuring its functions are effectively and efficiently discharged and its financial obligations are met. The Non-Executive Members and Executive Directors have been appointed, and our joint nomination process for the Partner Members is currently underway.
It has also been confirmed that we will have a number of Participants at Board meetings, in order to inform Board decision-making and the discharge of its functions. Participants do not hold accountability, do not have voting rights, but are invited at the discretion of the Chair in order to bring a broader perspective to the discussions and decision-making in the Board, particularly for items where they can bring a perspective relevant to their area of expertise. In Lancashire and South Cumbria, our Participants will include the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector and Healthwatch.
Constitutions for the Integrated Care Boards across England have been published on the NHS England website.
ICB Board members
Award of contracts
With regards to the award of contracts, the Health and Care Act 2022 removes the requirement for the NHS to be bound by current competition laws and use collaborative approaches to work with individual and groups of providers. New guidance is expected later this year which we expect will provide further information on the processes to be used to award contracts to new and existing providers.
Health and Care Act 2022: A new law regarding health and social care provision which originated in the House of Commons in July 2021 and completed the Parliamentary process in April 2022. Amongst other things, the new legislation aims to tackle health inequalities and create safer, more joined-up services that will put the health and care system on a more sustainable footing.
Integrated Care System (ICS): Refers to the health and care system across Lancashire and South Cumbria. There are 42 ICSs across the country. Within each ICS there is an Integrated Care Partnership and an Integrated Care Board.
Integrated Care Partnership (ICP): The broad alliance of organisations and representatives concerned with improving the care, health and wellbeing of the population, jointly convened by local authorities and the NHS. In Lancashire and South Cumbria, this will be known as the Lancashire and South Cumbria Health and Care Partnership. This term has now started to be used in the most recent national guidance. However, this is different to how we have used this term previously. It was previously used to describe our five place-based partnerships.
Integrated Care Board (ICB): Under the Health and Care Act 2022, this is the new NHS organisation that will be established on 1 July 2022. Locally, the Integrated Care Board will be known publicly as NHS Lancashire and South Cumbria. CCGs will be closed down and their functions will transfer to the new organisation, which will be responsible for NHS spend and the day-to-day running of the NHS in Lancashire and South Cumbria.
More definitions can be found in our glossary of terms.