NHS Integrated Care Systems: What have we learnt so far?

NHS staff standing in a circle working together, shot from above.

Integrated Care Systems (ICSs) were created to provide better patient care through greater inter-organisational collaboration. 


To explore this concept, we heard from Dean Royles, President of the HPMA, and Natalie Ibrahim, Workforce Programme Lead at NWL ICB People Programmes in a recent webinar.


Keep reading to discover: 


  • Key learnings from this session
  • Practical actions ICSs can take to overcome current workforce challenges
  • How this can help you meet your objectives going forward


What are the current workforce challenges facing NHS Integrated Care Systems?


NHS England has reported a budget deficit of £2-3bn across healthcare organisations in England alone. As a result, there is more pressure than ever for NHS Integrated Care Systems to make savings. 


To create these necessary cost efficiencies, the recent NHS 2023/24 priorities and operational planning guidance set an annual efficiency target of 2.2%. To meet this target, organisations are recommended to consider streamlining their workforce planning and management processes.


Alongside support from various toolkits (including the Bank Development Toolkit for temporary staffing management), collaboration has been identified as a key way to create efficiencies and save money. Prioritising collaboration can also increase staff retention, and transform how clinicians are deployed in line with patient demand.


What impact are outdated workforce solutions having on NHS Integrated Care Systems?


Whilst progress has been made to meet these objectives, many Integrated Care Systems are still forced to use outdated, fragmented workforce solutions that slow down transformation efforts. Here’s why:


  • The ICS structure has created a variety of new job roles, processes and targets. However, legacy staffing system architecture is yet to catch up with this evolving landscape. This means the digital support is not yet in place to make a genuine impact. 
  • Although ICSs have brought together organisations that previously operated in siloes, the NHS’s various care settings and sectors remain disjointed. This is partially due to the lack of integration between workforce management technology that supports each area. 
  • While NHS workforce solutions diversified and scaled rapidly during the COVID-19 pandemic, much of the funding required to sustain this innovation has been removed. As a result, ICSs risk returning to previous systems that are not fit for purpose.


But importantly, there is hope. 


What positive steps can NHS Integrated Care Systems take to restore healthcare staffing?


The COVID-19 pandemic showed us that it’s possible to provide flexible working opportunities and redeploy staff safely across organisations to meet demand.


Below are a number of recommendations from Dean and Natalie around how workforce teams and technology suppliers can continue working together in this way going forward:



  • Focus on collaboration, not competition when it comes to temporary staffing. When done effectively, sharing a pool of approved staff who can work flexibly across organisations can boost retention and fill vacancies.
  • While the COVID-19 pandemic required short-term staffing solutions to maintain patient safety, organisations should now start creating longer term strategies. For example, recruiting for long-term vacancies is often more cost-effective than relying on adhoc agency locums, and improves continuity of patient care.
  • Filling all your shifts with substantive workers is, of course, the best-case scenario. However, in practice it’s rarely possible, which is why organisations will always require a certain level of support from a contingent workforce pool. It is therefore important that NHS Integrated Care Systems give equal attention to the needs of temporary bank staff, and ensure they can easily, safely and flexibly work shifts across organisations.  


Staffing teams

  • Focus on onboarding and payment. With smooth onboarding and payment processes, data shows that NHS bank staff are more likely to book and work available shifts. 
  • Similarly, releasing bank shifts as far in advance as possible is proven to increase fill rates by 50%. This best practice means NHS Integrated Care Systems are more likely to plug gaps with cost-effective bank staff, rather than outsourcing to agencies. 


Technology suppliers

  • It’s crucial that any workforce technology provider offers organisations maximum visibility of staffing data. This enables ICSs to collectively make data-driven decisions to improve workforce planning, and reduces the administrative burden of creating reports.
  • Providers also need to go above and beyond to support their NHS partners. This means working closely from implementation, to go-live and beyond to ensure they get the most out of their solution, without increasing their workload. If anything, NHS Integrated Care Systems should see a reduction in manual admin with an effective workforce management solution in place. 


Ultimately, there are still many hurdles for ICSs to overcome when it comes to staffing. 

However, it’s also clear that there are a number of solutions to current challenges if organisations work together. 

Find out how to establish a safe, sustainable and collaborative staffing solution with Patchwork Health