How ICS working is critical to the success of the NHS Long-Term Workforce Plan
Integrated Care Systems (ICSs) were introduced in July 2022 to bring together NHS organisations, local authorities and others to collectively manage healthcare planning and strategy across geographical regions.
They had already existed informally since 2016, but the passage of the 2022 Health and Care Act turned them into legal entities with statutory powers and responsibilities. Since then, they’ve been an essential channel for delivering the government’s ambitions for the NHS.
It follows, then, that they also have a crucial role in making the vision of the Long-Term Workforce Plan a reality.
In this blog, we’ll take a look at what is expected from ICSs in the workforce plan, and why ICS-wide collaboration is so important to realising its aims.
What actually is an ICS?
The workforce plan defines an ICS as a system that brings “NHS organisations together with local authorities and wider system partners to improve population health and healthcare, tackle unequal outcomes and access, enhance productivity and value for money, and help the NHS support broader social and economic development.” (107)
As seen above, ICSs have a number of broad and far-reaching responsibilities that must be delivered collaboratively and equitably. They represent a fundamental shift in the way healthcare is organised in England. Where previously the emphasis was on organisational autonomy and competition, the integrated care model is founded on place-based collaboration.
This shift is necessary due to the changing needs of the population. People are living longer, meaning they more often face multiple and complex health challenges that require long-term support from a variety of providers. Therefore, more joined-up, collaborative care is needed to meet their needs effectively.
‘One workforce’
The NHS sees ICSs as a way to create ‘one workforce’. This is an important concept in recent NHS literature, including the workforce plan. It represents breaking down barriers between staff groups, between health and social care, and between NHS organisations. It also shows a commitment to creating a workforce representative of the community it serves, making it an important arm of its diversity and inclusion strategy.
The creation of ‘one workforce’ is intended to both bolster recruitment and retention efforts, as well as form more fluid ways of working that can better meet the needs of an ageing population.
What are ICSs responsible for delivering?
Guidance from the NHS outlines the 10 functions of an ICS as follows:
- Supporting the health and wellbeing of all staff
- Growing the workforce for the future and enabling adequate workforce supply
- Supporting inclusion and belonging for all, and creating a great experience for staff
- Valuing and supporting leadership at all levels, and lifelong learning
- Leading workforce transformation and new ways of working
- Educating, training and developing people, and managing talent
- Driving and supporting broader social and economic development
- Transforming people services and supporting the people profession
- Leading co-ordinated workforce planning using analysis and intelligence
- Supporting system design and development
From this, we can see that everything flows out of a desire to make the NHS a positive, fulfilling place to work. New, more inclusive, more flexible careers are clearly a priority, as are the systems that enable them. The workforce plan is therefore founded on the belief that by pursuing these on a regional scale, ICSs will be able to better care for patients, particularly those with complex health needs.
Now, let’s look at some of the ways these functions might look in practice.
Collaborative banks
Collaborative staff banks, which enable staff to safely pick up bank shifts beyond the boundaries of just one trust, are strongly recommended in the workforce plan.
According to the workforce plan, nearly half of all trusts in England are members of the 23 collaborative banks currently in operation nationwide. Their popularity with both staff and organisations is undoubtedly a result of the flexibility they offer. For staff, they provide an even greater breadth of shift types, specialities, and sites to choose from, allowing them to pick the shifts that best suit them. For organisations, they provide the flexibility to deploy staff to the areas of greatest need, as well as a cost-effective alternative to agency staff.
Importantly, the workforce plan pledges to support the wider NHS to adopt them, emphasising the importance of “fostering effective relationships between partners and trusts and investing in technology that makes it easier for staff to accept a temporary shift.” (56). This makes now a good time to start thinking about how a collaborative bank might look for you, if you haven’t already.
Systems-based rotational training
The workforce plan advocates for greater collaboration on training and education across ICSs; systems-based rotational training is one example of this. This more fluid form of career development would extend “the provision of placements across primary, community and social care, and in the independent and voluntary sectors, to give students valuable experience in the delivery of care outside hospitals and introduce them to wider career opportunities.” (81)
The Staffordshire and Stoke-on-Trent Health and Care Apprenticeship Scheme is a useful example of this. The ICS worked with NHS partners, Skills for Care, and local authorities to together build a rotational programme for apprentices. Targeted at young people from diverse and hard-to-reach backgrounds, this programme allowed participants to rotate through different health and care settings. The results have been overwhelmingly positive: 53 apprentices have since been recruited, and 76% have remained in health and social care.
Workforce planning
As the needs of the population change, more flexible and creative approaches to workforce deployment will be essential to meeting demand. As the workforce plan says, “It is crucial we embed an integrated approach to planning and delivery, bringing together workforce planning with service and clinical strategies and financial planning for the long term, so we have a sustained and responsive approach that reflects changes in demand, services and wider factors.” (25)
Some ways this could be achieved include:
- Joint training
- Joint teams
- Rotational programmes (as above) between NHS and social care settings
Collaborative banks are another useful tool for facilitating this. As they allow an ICS to jointly plan and deploy staff to the areas of greatest demand, they ensure staffing provision is always being used most efficiently to meet patient need.
Volunteering
The plan acknowledges that the volunteer workforce has a lot of untapped potential. Though an important aspect of the staffing mix, institutional support and infrastructure for it varies from organisation to organisation.
However, following the establishment of the NHS Volunteering Taskforce in 2022, the value of volunteers for integrated care has become clear. Consequently, ICBs are encouraged to “ICBs “embrace volunteering as part of their overall workforce plan, giving due consideration to programmes that support volunteering as a route into the workforce, such as NHS Cadets and Volunteer to Career.” (57)
Conclusion
In conclusion, Integrated Care Systems are critical to the success of the NHS Long-Term Workforce Plan.
The workforce plan is ambitious, calling for a rethink and expansion of many aspects of healthcare staffing. Crucially, collaboration is at the heart of it, and so it’s only ICSs that can deliver the changes necessary to secure the future of the NHS.
We hope that this blog has given you some insight into your function as an ICS, as well as some inspiration as to where you might want to focus your collective efforts next.
