Health and Care Bill granted Royal Assent

Date posted: 9th June 2022

The Health and Care Act will come into force on Friday 1 July 2022. The Act creates Integrated Care Systems (ICSs) which replace Clinical Commissioning Groups (CCGs). The commissioning function, which buys services on behalf of communities, is set to change.

The Act also encourages greater collaboration between services and organisations, to focus on ‘person centred care’. 

In Lancashire and South Cumbria, a number of organisations have been working in a more collaborative way for several years. This includes NHS organisations, local authorities, the voluntary, community, faith and social enterprise (VCFSE) sector, hospices and local universities.

Bay Health and Care Partners, the Place-Based Partnership for Morecambe Bay, is part of an Integrated Care System (ICS) called Healthier Lancashire and South Cumbria.

This ICS has existed for quite some time already, as these plans were part of the 10-year plan from NHS England, However, the new Act establishes the ICS as a statutory organisation. The ICS is split into two parts: Integrated Care Boards are the ‘NHS’ side of the new organisation. This will sit alongside the creation of Integrated Care Partnerships, which is a wider partnership between the NHS, voluntary, community and faith sector and Local Authorities. This will be a broad alliance of organisations and representatives concerned with improving the care, health and wellbeing of the population.

Colleagues in the CCGs will be transferring to the ICS, however there will still be local representation here in Morecambe Bay, through Bay Health and Care Partners.

The Act provides for £36bn of funding over the next three years to tackle the effects of the Covid-19 pandemic through the Health and Care Levy, which will subsequently be focused on social care. It also contains measures to tackle health disparities and create safer, more joined-up services that will put the health and care system on a more sustainable footing.

The aims of Bay Health and Care Partners are strengthened by this change in legislation, since we have been developing closer integration for a number of years. Projects such as Set for Surgery, which strengthen ties between primary and secondary care, were developed here in Morecambe Bay and are now being rolled out across the ICS.

This helpful graphic from the NHS Confederation sets out the different levels of focus for the new ways of working.

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The Act also aims to:
make services safer by establishing the Health Services Safety Investigations Body, an independent public body which will investigate incidents that have implications for patient safety and help improve systems and practices

  • ensure our health and social care workforce have the right skills and knowledge to provide informed care to autistic people and people with a learning disability by making specialised training (the Oliver McGowan Mandatory Training) mandatory by law
  • safeguarding women and girls by banning the harmful practices of virginity testing and hymenoplasty
  • address the barriers to joined-up working, by supporting data sharing between health and social care and removing barriers in the hospital discharge process, reducing unnecessary delays for patients
  • explicitly set out the parity of mental health and physical health and ensure transparency around the spending allocated to mental health support

As part of these changes, individual trusts and other providers will still keep their current duties or accountabilities, but will work more closely with other providers in an area; for example, to address the backlog of elective care, some patients may be offered treatment at a different trust. This increased partnership working is under an umbrella of a ‘Provider Collaborative’.

One of the main aims of the ICS is to enable local authorities, NHS organisations and other strategic partners including the VCFSE sector to work together more closely to improve patient care. By collaborating with different organisations who have responsibilities for different areas of health and care, the ICS will be better able to improve care for patients and communities. One example of this is social care which is provided by local authorities for adults and young people who have support needs. By jointly planning services together, each part of the health and care system can support changes and improvements within the other. This could be through workforce planning so that each area can deploy staff effectively, avoiding any duplication of services, or joint recruitment to make sure there are enough staff to keep services safe.

Local authorities, NHS and VCFSE organisations have a significant role to play in preventative health programmes. Whether that’s through the provision of fitness facilities or green spaces, or providing specialist support to people with specific conditions.

Find out more about integrated care developments in Lancashire and South Cumbria.

Place-Based Partnerships

In Morecambe Bay, the Place-Based Partnership (PBP) is called Bay Health and Care Partners. A Place-Based Partnership (PBP) is a collaboration of planners and providers across health, local councils, the VCFSE sector and the wider community who take collective responsibility for improving the health and wellbeing of residents within a place with a population of up to 500,000.

There are four other PBPs in Lancashire and South Cumbria and they cover the areas of, Fylde Coast, Pennine Lancashire, Central Lancashire and West Lancashire.

The core aims of PBPs are to:

• improve the health and wellbeing of the population and reduce inequalities

• provide consistent, high-quality services that remove unwarranted variation in services

• consistently achieve national standards/targets across the sectors within the partnership

• maximise the use of a place-based financial allocation and resources. Staff in each of the Partner organisations will play a vital role in achieving these core aims.

Find out more about Bay Health and Care Partners Place-Based Partnership here.

Provider Collaboration Board

A Provider Collaboration Board (PCB) was established in Lancashire and South Cumbria in June 2020. The PCB enables all acute, mental health and community providers to work together in partnership and within the ICS.

Locally the PCB aims to:

  • work collaboratively to meet significant health and care challenges
  • address inequalities across communities including Morecambe Bay
  • use a collective effort to address the level of unwarranted variation in the way communities get access to services and service outcomes
  • standardise good practice across all organisations involved to achieve a ‘good’ CQC rating within the next three years
  • move the significant duplication across the ICS so that resources can be reinvested more effectively and efficiently to ensure better patient care
  • retrain the workforce and attract excellent colleagues to the area, making Lancashire and Cumbria a great place to live and work.

The organisations currently involved are: Blackpool Teaching Hospitals NHS Foundation Trust, East Lancashire Hospitals NHS Trust, Lancashire and South Cumbria NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust and University Hospitals of Morecambe Bay NHS Foundation Trust.

Further resources

You can find out more at the following links:

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