Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services

Abstract

SUMMARY Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.

Why care about integrated care? Part 3. Weighing sunlight: delivering integration in practice and measuring success

“…All of this means that the status quo for already stressed systems is not viable. Part 2 (Tracy 2020b) outlined legislative, policy and structural changes emerging over the past decade. From the Five Year Forward View (FYFV – see part 2 for a full table of acronyms and initialisms) through to the NHS Long Term Plan, reduced bureaucracy and barriers, and better integration of services is a clear message for purported enhanced outcomes and savings, although the Social Care Green Paper remains a key missing element.…”

“…Primary care practices are undergoing their own changes, moving into primary care networks (PCNs, explained in part 2; Tracy 2020b) of practices covering ‘natural populations’ of about 30 000. The aim is to balance personalised care with some scale up of facilities.…”

“…Opportunities exist for new ways of working with external and third-sector agencies. A principle of integrated systems is place-based care – see part 2 (Tracy 2020b) – and being part of local communities. Although this is currently less explored in the first iteration of services, there are obvious novel opportunities to work with resources such as cultural, sporting and faith-based organisations.…”

“…Integrated care systems (ICSs) were described in part 2 (Tracy 2020b). It is intended that ICSs will allow long-term planning (and commissioning via the matched CCG) over a considerable geography and demography, aiming to minimise duplication and inefficiencies.…”

Integrated care systems: can they deliver?

“…The latest of these reforms is ‘integrated care systems’ (ICS), introduced in the 2019 NHS Long Term Plan (NHS England 2019). Tracy et al published a series of three articles on the subject which discuss the evolution of this model of care, the historical context, possible models of integration and approaches to evaluating this (Tracy 2020a, 2020b, 2022). They clearly outline the concept and opportunities and conclude by suggesting that there is a ‘very clear, unavoidable move towards more integrated services’.…”