06 Jan Time for ICSs to Talk the Talk
This week the OVID team has had a great time updating each other on our New Year’s Resolutions. But those who won’t be having as much fun discussing theirs are ICS leads, who will have been busy over the past week digesting the new 2023/24 priorities and operational planning guidance.
Commentators have called this the NHS’ lowest point ever, with members of both the right and the left deciding that some sort of reform is needed. But we’ve just had reform. The transition period is now coming to an end following the biggest piece of NHS legislation since 2012.
The current state of play in the NHS means these new models of care simply need to work. In the battle of priorities, at some point, the next five years is going to have to take precedent over the next five minutes. That moment should be this Spring.
By April, ICBs need to have produced their joint forward plans, and to go with them, we will have a new NHS Payment Scheme that aims to both support integration and incentivise elective activity to reduce the backlogs. And on paper at least, ICSs have the legislative footing and financial and capital allocations they need to plan, and an opportunity for greater autonomy and less performance micro-management moving forward through the Hewitt review.
There are a number of elephants in the room, not least workforce and social care. But given these do not have short term fixes, the ICSs must work with what they’ve got. What is more, if it is true that many Trusts are expecting to go into financial deficit next year, budgets for transformation and public health may be squeezed, meaning the problems we are witnessing in hospitals will likely need to be solved in hospitals.
With that in mind, the OVID team has come up with our shortlist of the most relevant actions NHSE has asked ICSs to complete:
- Expand direct access and self-referral where GP involvement is not clinically necessary.
- Successful implementation of this action will be a good sign that integration is working well.
- Increase productivity and meet the 85% day case and 85% theatre utilisation expectations, using GIRFT and moving procedures to the most appropriate settings.
- In a world where funding and capital allocations are fixed, it is productivity that will have to increase to help supply meet demand. The GIRFT reports have a number of recommendations that can make the best use of innovation, not all of which have been implemented.
- Deliver a minimum 10% improvement in pathology and imaging networks productivity by 2024/25 through digital diagnostic investments and meeting optimal rates for test throughput.
- Innovative diagnostics can be the catalyst for pathway transformation, helping to create an NHS that is fit for the future.
- Put the right data architecture in place for population health management.
- Unlocking the power of data could help to revolutionise the way health and care is delivered. But with the merger of NHSx and NHS Digital and a slimmed down NHSE, there is a big question mark in 2023 over the service’s ability to implement digital transformation.
- Maximise the adoption of innovative treatments.
- This one isn’t in the guidance, but is from us! We would love to see an NHS that improves the adoption of innovative technologies and medicines, such as cell and gene therapies, to transform patients’ lives.
We may not get time before the next election to know if the new NHS legislation proves to be a good move politically for the Conservatives. One thing seems apparent: the Government has decentralised control of the NHS during a time at which they are getting intensely criticised for its performance.
Tom Doughty, Senior Account Director