Members received the report on the Harrow Integrated Care Partnership - Next Steps on Integrating Care (Consultation and progress on future development of Integrated Care Systems in England).
It reflected a number of principles which were supported by and reflected in arrangements in NW London and Harrow ICP including: stronger partnerships at a place level between the NHS, local government and the voluntary and community sector; a focus on improving population health and tackling inequalities - including a “Triple Aim” duty for all NHS providers; the central role for primary care in providing joined-up care; the role of mutual aid development of relationships and support during the pandemic and opportunities to pool funding; the importance of data sharing and digital alongside a culture of collaboration and agile collective decision-making; the importance of local government and place in the planning, design and delivery of care; the principle of subsidiarity – the system taking responsibility only for things where there was a clear need to work on a larger footprint, as agreed with local places.
The document invited feedback by 8 January 2021. Whilst proposed legislative changes are unlikely before April 2022 and subject to parliamentary approval, the document set out an NHS direction of travel including requests for submission of ICS development plans by April 2021 and implementation plans by September 2021.
Discussions had highlighted the importance of clarity in relation to a number of areas, such as the Department of Health and Social Care White Paper published in February 2021. It was proposed that new arrangements should begin to be implemented in 2022.
Following on from the presentation, Members raised questions around: the implications of proposed changes for financial controls within the system; the role and powers of commissioning; collaboration between partners and the potential future increased involvement of the private sector in health provision; and the involvement of the voluntary and community sector, including its ability to operate at a local scale to address inequalities.
A further question was raised around the role of pan-London and cross-ICS working, including in areas such as investigating child deaths and improving support to learning disabilities.
Simon Morioka and Claire Kennedy, presenting, emphasised the importance of the continued development of place based arrangements, even in the absence of clarity in a number of areas and in advance of further guidance, to ensure that the population of Harrow benefitted from, and were not adversely impacted by, these changes.
This included in relation to the overlapping set of future responsibilities that would exist in relation to finances, and the ongoing and enhanced need for joint planning and assurance, irrespective of changes to commissioning structures.
The role of GPs and the voluntary and community sector in the Harrow response to Covid-19 was highlighted as an example of how joint working was already making a difference in local areas.
The Chair added that the role of partnership and trust in building relationships at an ICS and borough level was important.
The Vice-Chair welcomed opportunities for working collaboratively to address future challenges.
RESOLVED: That the report be noted.