Clinical commissioning groups scrapped for new NHS integrated care systems

Changes to how health care is managed

Today (Friday, 1 July) marks a significant change to the way health and care will be governed in Kent and Medway and across England.

From today, 42 statutory integrated care systems will bring together the NHS, councils and other partners to plan and deliver health and care services in their area. The aim is to  join up hospital and community-based services, physical and mental health, and health and social care.

The legal introduction of integrated care systems, via the Health and Social Care Act 2022, now sees clinical commissioning groups dissolved.

Integrated care boards – here the NHS Kent and Medway – will be leadership organisations supporting partners to more effectively join up care and place an emphasis on prevention.

Kent and Medway Integrated Care System (ICS) is a partnership that brings together partners, including NHS services, councils and others, to plan, co-ordinate and commission health and care services.

This is a shift in the way the health and care system is organised – away from competition and towards collaboration – with health and care organisations working together to improve population health.

In Kent and Medway all the NHS organisations and the Kent and Medway councils have been working together as a sustainability and transformation partnership (STP) since 2016. In April 2021 NHS England formally accredited the Kent and Medway as an Integrated Care System.

From now, the integrated care system will be given statutory responsibilities and the Clinical Commissioning Group will be replaced by the NHS Kent and Medway Integrated Care Board.

Kent and Medway has a population of 1.9million people and is one of the largest integrated care systems in the county.

The aim is to enable the 42 areas to transform health and care for people in their local communities, as well as cutting red tape. For example, boosting health checks in the community to find people with health problems before they become seriously unwell is a key goal of the shift to integrated care systems, where local organisations work together to better meet the needs of local people.

NHS Kent and Medway Chief Executive Paul Bentley said: “We know there are far too many people living with health inequalities across the communities we serve and this will be a major focus of our work. We know more has to be done to improve the outcomes for people and the experience they have when they need care.

“Much of what influences health is outside of health and care services, so we must enable and lead this change – we see every day the direct impact of poor health and care. Prevention is critical.

“The beginning of NHS Kent and Medway and the integrated care system that involves so many partners, including councils and the voluntary sector, is crucial to this.”

Kent and Medway Chair Cedi Frederick said: “We need more than organisational change; we need to create a movement that can bring every organisation together, work together and work differently so we can deliver something better for the people of Kent and Medway.”

Some controversy has arisen around whether these developments could open the door to privatisation of the NHS. Concerns were most prominent around the development of the integrated care provider contract (a new contractual form allowing commissioners to award a long-term contract to a single organisation to provide a wide range of health and care services to a defined population), with campaigners arguing that this could lead to health and care services coming under the control of private companies.

Two judicial reviews were brought against NHS England in relation to the contract, but both were dismissed. The NHS Long Term Plan subsequently set an expectation that integrated care provider contracts would be held by public statutory providers.