In 2016, NHS organisations and local councils within geographical areas joined together into a set of Sustainability and Transformation Partnerships (STPs) covering all of England. The intention was that this would help planning, coordinating and prioritising health and care needs for their populations. In a round of planning guidance in 2018/19, NHS England then announced that all STPs were now to become ‘Integrated Care Systems’ (ICSs); advanced versions of STPs. ICSs are intended to overcome barriers between hospitals, mental and physical health services, local authorities, primary care and the wider public health system, including schools and housing. Until July 2022, ICSs were voluntary partnerships but, following the passage of the 2022 Health and Care Act, they were formalised as legal entities with statutory powers and responsibilities.
Over the course of a two-year School for Public Health Research project, the research team set out to detail the development of ICSs for children and young people (CYP) and, more broadly, to understand what integrated care means for this age group. Using a variety of approaches, including survey, qualitative interviews, literature reviews and youth engagement, they worked with ICS leaders and young people to map out who is doing what and where, what are the key components for understanding effective integrated systems for CYP, and how integration within CYP healthcare systems and networks could be measured.
What does this mean for public health professionals?
Integration is a long-term process and, to fully understand the impacts on CYP, ongoing evaluation will be needed. This project set out the baseline and starting point, and highlighted some of the initial issues around building these integrated systems. While there is much support for the principle of integrating services for CYP, in practice this is quite a challenge. This arises in part from a need for more focus specifically on this age group, but also from common challenges involved in developing joined-up services. Often success is dependent upon leadership but also to allowing time and resources to allow innovation to bed down and for partnerships to build. Hearing young people’s perspectives about what works is also critical to getting it right for this age group. Finally, the COVID-19 pandemic has had an impact on ICS progress and CYP service provision. While predominantly negative there have been some positive ramifications, including strengthened working relationships, new efficiencies, and opportunities for virtual collaboration.