In February 2021, The Health and Social Care Secretary, with the support of NHS England and health and care system leaders, set out new proposals to build on the successful response to the pandemic. The proposals were detailed in a Government White Paper for NHS and social care reform titled, 'Working together to improve health and social care for all' and aim to bring health and care services closer together to build back better by improving care and tackling health inequalities.
The measures set out in the White Paper, will modernise the legal framework to make the health and care system fit for the future and put in place targeted improvements for the delivery of public health and social care. It will support local health and care systems to deliver higher quality care to their communities, in a way that is less legally bureaucratic, more accountable and more joined up, by bringing together the NHS, local government and partners together to tackle the needs of their communities as a whole.
The proposals also build on the NHS’ recommendations for legislative change in the NHS Long Term Plan.
What are the changes proposed?
The Black Country Integrated Care Partnership (ICP)
Each ICS will have a partnership at system level established by the NHS and local government as equal partners.
This will bring together NHS, local government and other partners to move forward with improving health and wellbeing. The ICS Partnership is expected to develop an 'Integrated Care Strategy' based on Joint Strategic Needs Assessments. The Government does not intend to bring forward prescriptive legislation to say how partnerships should operate. The ICS NHS Body and local authorities must jointly select a Partnership Chair and define their role, term of office and accountabilities.
The Black Country Integrated Care Board (ICB)
This new organisation will lead integration in the NHS, bringing together all those involved in planning and providing NHS services.
The Black Country Integrated Care Board will be a NHS statutory organisation (there will be no statutory role in place until April 2022, subject to the passage of legislation) which will be:
- Working with the Health and Care partnership to Develop a planto meeting the health care, social care, public health and population health needs of the population
- Allocating resourcesto deliver the plan
- Establishing joint working arrangementsand can choose to commission jointly with local authorities
- Establishing governance arrangements- underpinned by statutory and contractual responsibilities to ensure the plan is within the system financial envelope
- Arranging for the provision of health services
- Putting contacts and arrangements in place to secure delivery of it's plan by providers
- Convening and supporting providers to lead major service transformation programmes
- Working with local authorities and Voluntary Community and Social Enterprise (VCSE) partners to put in place personalised care for people
- Leading system implementation of the People Plansupporting a 'one workforce' model
- Leading system-wide action on data and digitalto put the citizen at the centre of their care
- Using this data to understand local priorities, track delivery plans and monitor variation
- Working with councils to invest in local community organisations and infrastructure
- Drive joint working on estates, procurement, supply chain and commercial strategiesto maximise value for money
- Planning for, responding to and leading recovery from incidents (EPRR)
- Receiving the functions that NHS England and NHS Improvement will be delegating, including commissioning of primary care and appropriate specialist services.
It is expected Clinical Commissioning Group (CCG) functions, duties, assets and liabilities will transfer to an ICS NHS body. Statutory duties around children in care and special educational needs and disabilities (SEND) will apply to ICS ICBs as CCGs are abolished.
ICS development across the Black Country and West Birmingham
Since the Government set out plans to establish ICSs on a statutory basis, health and care partners across the Black Country and West Birmingham have been working together to get ready for any changes.
A key responsibility for our system will be to support place-based joint working between the NHS, Local Government and other partners such as the voluntary and community sector. The White Paper proposes that frequently, place level commissioning within an integrated care system will align geographically to a local authority boundary, and the Better Care Fund (BCF) plan will provide a tool for agreeing priorities. The boundaries for some ICSs, including our own, have been reviewed with the decision made nationally that the West Birmingham geography will join Birmingham and Solihull ICS. We will work with our colleagues in the Birmingham and Solihull ICS and with our local stakeholders to ensure we continue to work collaboratively for the mutual benefit of the people who live in West Birmingham and the staff responsible for delivery of health and care services, to ensure a smooth transition.
Who will lead the new ICS?
In July 2021 following a robust process, NHS England and NHS Improvement recommended, and the Secretary of State agreed, that Mr Jonathan Fellows should be the chair designate of the NHS Black Country Integrated Care Board, and ready to take up the post substantively when the changes come into effect.
Since November 2021 Mr Mark Axcell has been acting as the interim CEO Designate for the Black Country ICB.
Mark is working with the CCG leadership to ensure the safe landing of the CCG functions into the new statutory ICS and he will, alongside other system leaders, provide inspirational leadership across the system to help us create healthier futures for local people.
Integrated Care Board Chair Designate: Mr Jonathan Fellows
Integrated Care Board CEO Designate: Mr Mark Axcell (Interim)
Non-executive members for the Black Country Integrated Care Board
Five new non-executive directors have been appointed as the Black Country prepares to take partnership working across health and care to the next level.
The five appointments which have been made to the ICB designate are:
- Mr Alan Edwards, Audit Committee Chair
- Mrs Gianjeet Hunjan, Chair of the Finance, Performance and Digital Committee
- Dr Sonia Ashraf, Chair of the Quality and Safety Committee
- Mr Ranjit Sondhi CBE, Chair of the Remuneration and People Committee
- Bishop Llewellyn Graham, Non-Executive Director for Inequalities
Read more about these appoinments here
Executive Recruitment for the Black Country Integrated Care Board
The Black Country Integrated Care System is looking for future Executives to lead the Integrated Care Board when it is established in July 2022. Find out more.
Key questions and answers
What do we mean when we say Integrated Care System?
Integrated Care Systems are partnerships and collaborations between different organisations which support people’s health and care in a defined geographic area. They are not one organisation, not a single entity and cannot be an employer.
Our Integrated Care System will include NHS organisations, councils, and others all working together to help achieve our common vision of improving the health and wellbeing of local people.
Locally we use the term Healthier Futures to describe our system as we are all working together to create a healthier future for local people.
Our future Integrated Care System will be known as the Black Country Integrated Care System (ICS).
What do we mean when we say Integrated Care Partnership?
The Black Country Integrated Care Partnership will be formed by the Integrated Care Board and Local Authorities on the 1st July 2022 (subject to legislation). This committee will replace our current Partnership Board and will set the health and care priorities.
Our Integrated Care Partnership will be known as The Black Country Integrated Care Partnership (ICP)
What do we mean when we say Integrated Care Board?
Our Integrated Care Board will be an NHS organisation, replacing the current Clinical Commissioning Group and adopting its statutory functions along with some of those from NHS England.
It will be responsible for the national legal requirements and functions including allocation of, and accounting for NHS resource. In the future, the ICB is expected to take more responsibility for Primary Medical Services (GPs), Dental, Optometry and Pharmacy. The ICB is also expected to take more responsibility for specialised services working on a multi-ICS footprint. These services are currenty commissioned by NHS England (except for primary medical services which are currently delegated to CCGs).
Our Integrated Care Board will be known as NHS Black Country Integrated Care Board or NHS Black Country for short.
What do we mean when we say Place Based Partnerships?
Place Based Partnerships are collaborative arrangements that have been formed by the organisations responsible for arranging and delivering health and care services in a locality or community. They involve the NHS, local authorities and providers of health and care services, including the voluntary, community and social enterprise sector (VCSE), people and communities. They often include other community partners that have a role in supporting the health and wellbeing of the population and addressing health inequalities, such as housing associations, skills and education services and local business.
Locally they play an important role in the coordination and improvement of service planning and delivery and in reflecting and representing local communities.
It is intended that there will be four Place partnerships in our ICS: one each in Dudley, Sandwell, Walsall and Wolverhampton.
What do we mean when we say Provider Collaboratives?
Provider Collaboratives are partnership arrangements involving at least two NHS trusts working at scale across multiple places, with a shared purpose and effective decision-making arrangements, to:
- Reduce unwarranted variation and inequality in health outcomes, access to services and experience
- Improve resilience by, for example, providing mutual aid
- Ensure that specialisation and consolidation occur where this will provide better outcomes and value.
Provider collaboratives work across a range of programmes and represent just one way that providers collaborate to plan, deliver and transform services. Collaboratives may support the work of other collaborations including clinical networks, Cancer Alliances and clinical support service networks.
Primary Care collaboratives create the opportunity for improving integrated working across the public’s front-door to the NHS: transforming the way in which services are organised to improve the sustainability of services; enhancing primary prevention support to the public; offering patients with diverse needs a wider choice of personalised, digital-first health services; and bringing together best practice to improve consistency in access to care, diagnosis and treatment.
What does it mean for the West Birmingham Place?
In July 2021, the Department of Health and Social Care formally announced that future Integrated Care Systems across the country will be aligned to Local Authority boundaries. Locally, this means that the place of West Birmingham, currently in the Black Country and West Birmingham System, will move to the Birmingham and Solihull Integrated Care System (ICS) (subject to legislative changes going through Parliament).
This change to our ICS boundaries will not directly affect current NHS provision of services and we want to be clear that existing commitments (e.g. capital investments) will not be affected. Locally, we have been working together to develop strong relationships between our neighbouring systems in anticipation of this change, and this will continue. Our priority over the coming months will be to achieve a safe landing into the new NHS infrastructure. In light of this announcement, we will take stock of the work already undertaken and work with local stakeholders to ensure we continue to work collaboratively for the mutual benefit of the people who live in West Birmingham and the staff responsible for delivery of health and care services, to ensure a smooth transition.
The announcement regarding the decision made by the Department of Health and Social Care can be found here.
Subject to the Health and Care Bill securing Royal Assent, the transfer of the West Birmingham Place to Birmingham and Solihull ICS will now take effect from 1 July 2022. This transfer date will ensure synergy with other boundary changes that are happening across the country, will afford us more time to ensure a smooth transition and will align with the establishment of ICB and ICP new governance structures. Importantly, the 1 July transfer also ensures we can maintain the NHS commitment to minimise the impact on staff; this means that our current staff will only have to go through one organisational change process.
Locally, we have been working together to develop strong relationships between our neighbouring systems in anticipation of this change, and this will continue. Our priority over the coming months will be to achieve a smooth and effective transition. We will take stock of the work already undertaken and will re-align relevant aspects of the plan alongside a commitment to continued engagement with local stakeholders. Our priority remains to ensure the smooth transition of services, for both the people who live in West Birmingham and the staff responsible for delivery of health and care services.
Keep up to date with developments
We are committed to updating stakeholders on this work as it develops. Download our stakeholder newsletters for more information.