Why the evolving role of local government and ICSs matter for discharge

Today we launched our report ‘The evolving role of county authorities in Integrated Care Systems’ at the County Councils Network (CCN) Annual Conference. At the panel discussion, which included Professor Claire Fuller and Rachael Shimmin OBE, Chief Executive of Buckinghamshire Council, all recognised the timeliness of this report. As the panel discussed, our report, taken together with the Fuller Stocktake Report and the forthcoming Hewitt Review, presents a new opportunity to focus on delivering better outcomes that cost less across Integrated Care Systems (ICSs).

While the report is comprehensive, making 20 recommendations, three issues in particular stand out:

1. The need for central government to embrace the devolution it claims to promote
2. The extent to which ICSs represent true partnership working, and the need to agree a small number of priorities where a difference can truly be made, and;
3. The role and prominence of “Place” in NHS and council decision-making

On the second, the continued concern and pressures discharge is having across many, if not all, systems, should sit top of this list for joint, focused endeavour. The Autumn Statement hasn’t diluted this. Even though the announcement on funding should be recognised as a huge support to the sector, the need for transformation and empowerment is still as critical as ever to support day-to-day reablement and better outcomes to residents.

As Simon Edwards, Chief Executive of CCN, told the MJ today: ‘we must begin to shift the Integrated Care Systems’ culture sooner rather than later’.

Through our Valuing Home work, we have supported health and care partners to work differently – focusing on applied behavioural change to support more residents to get home soon, before then building out the new models of care which are required to sustainably drive this further.

In contrast to our report which relays an accurate quote from an ICB Chair that ‘once you have seen one ICS, you’ve seen one ICS’, the challenges being faced across discharge are often similar. They are often rooted in culture and behaviours, and complicated by processes and forms that have evolved at speed through the pandemic. Putting workforce planning and a medium-term financial plan in place to manage the new levels and cadence of demand is crucial as we go into this winter and the planning year to come.

The key is to make sure an inclusive ambition for discharge is a system-wide agreed top priority, and one of only a very few, so that it can be tackled jointly by local government, the NHS and voluntary, community and social enterprise (VCSE) organisations. Do get in touch to talk to us more about our approach and impact from Valuing Home and how it can support you.