The NHS in England is changing its structures and processes for deciding how resources are used once again. From 1 July, clinical commissioning groups (CCGs) will be abolished and every area of England will fall into one of 42 ‘Integrated Care Systems’.
These new arrangements bring with them a whole new lexicon of names and acronyms. So here’s a quick jargon-busting guide for anyone wanting to understand what it all means.
Integrated Care System (ICS)
Every area in England is now included within one of 42 ICSs. They cover populations of around one million (but there is wide variation, some much smaller, others much bigger). To find out which ICS you live in, NHS England have published this map. Decisions about how NHS funds are spent and how health and social services will work in the future will be made at this level from now on.
Integrated Care Board (ICB)
Each ICS will have a Board which will make decisions about how NHS funding is spent in its area. Each board will have representatives of the NHS trusts (that provide services such as hospitals, community and mental health care), local councils with responsibility for social services and other key bodies in the area. Every board has, by law, to include at least one member with expertise relating to mental health. They are also required to produce annual plans for health and care services in their area.
Integrated Care Partnership (ICP)
Each ICS will also have a Partnership which will have a wider membership than the Board. This could include members representing the voluntary and community sector, or other public services such as housing and policing. Its role will be to set the overall strategy for the ICS: it is required to produce a five-year strategy and it is expected to link up with Health and Wellbeing Boards in its area. (Health and Wellbeing Boards are statutory bodies led by upper tier local authorities who are responsible for creating health and wellbeing strategies for their areas.)
Primary Care Network (PCN)
All general practices in England have been brought into clusters known as primary care networks. They are given specific responsibilities for improving primary care services in their local areas and they can get access to additional funding to employ workers to fill gaps in existing services. Some PCNs are now bringing in mental health workers under this scheme.
All NHS trusts (that provide services such as hospitals, community and mental health care) are required to join at least one ‘provider collaborative’. The aim of these new arrangements is to encourage better joined up working between the different organisations that provide people with health services. Some provider collaboratives bring together different mental health trusts across a large area (for example to improve care support for children needing urgent care) while others bring together different types of trust (for example joining up mental health, acute and community services to integrate support for people with more complex needs).
In the jargon of the new set-up, ‘system’ refers to the geographical area covered by each ICS. So any decision being made at ‘system level’ will apply to the whole area and its health and care services.
This refers to geographical areas within a system. In many cases, they mean the areas covered by an upper tier local authority. Some integrated care systems, especially the larger ones, have decided to delegate decision-making about how services are planned to ‘place’ level. In these cases, they are allowed to set up ‘Place-Based Partnerships’ that have delegated responsibility for particular types of service.
This describes the area covered by a Primary Care Network. Current plans for improving primary and community mental health services encourage greater collaboration at this ‘neighbourhood’ level so that people get better access to support that’s close to home.
Let us know if there’s any other jargon you want us to try and decode.