NHS Future Plans

With so much change going on in the world of health and care, whether that’s in Portsmouth, the local region and across the country, we wanted to provide local people with more information explaining what is happening.

How does does the NHS in England work and how is it changing?

The Kings Fund have produced an animation ‘How does the NHS in England work and how is it Changing? which explains what key organisations make up the NHS, and how they can collaborate with partners in the health and care system to deliver joined-up-care.  With the advent of the 2022 Care Act, changes are being made, and this will affect how things work within the NHS. View the animation to see what the changes are, how they are being implemented and when these changes will be happening.

Integrated Care Systems (ICS) What will be in place from April 2022 for Hampshire and the Isle of Wight, including Portsmouth area

From April 2022 there will be an Integrated Care System (ICS) for the Hampshire and Isle of Wight area (which includes the city of Portsmouth).    The ICS exists in shadow form as it develops all the systems to be in place ready for 1st April 2022.   Portsmouth City Council and Portsmouth Clinical Commissioning Group are working with the shadow Hampshire and Isle of Wight ICS (HIOW ICS) to plan the future of health and care provision.  More information about the detail for Portsmouth City and the updated Portsmouth Blueprint (for health and care) will be available later in the year.  In the meantime you may be interested to read what the Kings Fund have developed as an explanation of what will be in place from April 2022 across England:

Integrated care systems

The statutory ICS will be made up of two key bodies – an integrated care board (ICB) and integrated care partnership (ICP).

Integrated care boards

Integrated care board (ICBs) will take on the NHS planning functions previously held by clinical commissioning groups (CCGs) and are likely to absorb some planning roles from NHS England. ICBs will have their own leadership teams, which will include a chair and chief executive, and will also include members from NHS trusts/foundation trusts, local authorities, and general practice, selected from nominations made by each set of organisations. In consultation with local partners, the ICB will produce a five-year plan (updated annually) for how NHS services will be delivered to meet local needs. In developing this plan and carrying out their work, the ICB must have regard to their partner ICP’s integrated care strategy and be informed by the joint health and wellbeing strategies published by the health and wellbeing boards in their area. Additionally, each ICB must outline how it will ensure public involvement and consultation.

ICBs will also contract with providers to deliver NHS services and will be able to delegate some funding to place level to support joint planning of some NHS and council-led services.

Integrated care partnerships

Integrated care partnerships (ICPs) will operate as a statutory committee, bringing together the NHS and local authorities as equal partners to focus more widely on health, public health and social care. ICPs will include representatives from the ICB, the local authorities within their area and other partners such as NHS providers, public health, social care, housing services, and voluntary, community  and social enterprise (VCSE) organisations. They will be responsible for developing an integrated care strategy, which sets out how the wider health needs of the local population will be met. This should be informed by any relevant joint strategic needs assessments (see below). In developing its integrated care strategy, the ICP must involve the local Healthwatch, the VSCE sector, and people and communities living in the area. ICPs will not directly commission services.

Partnership and delivery structures

A number of partnership and delivery structures will operate within an ICS at system, place and neighbourhood level.

NHS providers will work together at scale through provider collaboratives, new partnerships operating across ICSs to improve services. Provider collaboratives, which may involve voluntary and independent sector providers where appropriate, are expected to be operating across England by April 2022 and will agree delivery objectives with partner ICSs.

Health and wellbeing boards (HWBs) are formal committees of local authorities that bring together a range of local health and care partners to promote integration. They are responsible for producing a joint strategic needs assessment and a joint health and wellbeing strategy for their local population.

Place-based partnerships operate on a smaller footprint within an ICS, often that of a local authority. They are where much of the heavy lifting of integration will take place through multi-agency partnerships involving the NHS, local authorities, the VCSE sector and local communities themselves.

Primary care networks (PCNs) bring together general practice and other primary care services, such as community pharmacy, to work at scale and provide a wider range of services at neighbourhood level.

National bodies

The NHS organisations within ICSs, including ICBs, NHS trusts and foundation trusts, will be accountable to NHS England for their operational and financial performance. The Care Quality Commission (CQC) will independently review and rate the quality of partnership working within ICSs, alongside its existing responsibilities for regulating and inspecting health and care services.

Here is a link to a diagram produced by the Kings Fund to show how the new health and care structure fits together

2020 Coronavirus pandemic

Coronavirus legislation affecting healthcare:

Here is a link to an Overview of Coronavirus Act 25th March 2020

Here is a link to the full legislation

Coronavirus legislation affecting adult social care support:

Here is a link 16.4.20 Government action plan for adult social care during COVID-19

Here is a link 15.5.20 Government support for care homes during Coronavirus pandemic

NHS planning prior to Coronavirus pandemic

Building on the NHS Long Term Plan, the Government has issued the White Paper on NHS and Social Care which will be presented to parliament later this year and implemented next April.

Here is the Healthwatch England summary of the White Paper.


Have your say on the Health and Care Bill

Do you have relevant expertise and experience or a special interest in the Health and Care Bill 2021-22, which is currently passing through Parliament?

If so, you can submit your views in writing to the House of Commons Public Bill Committee which is going to consider this Bill.

Aims of the Bill

The Bill would enact policies set out in the NHS’s recommendations for legislative reform, following the NHS Long Term Plan (January 2019), and the White Paper, Integration and Innovation: working together to improve health and social care for all (February 2021).

The Government says the Bill builds on the NHS’s own proposals for reform, aiming to make it less bureaucratic, more accountable, and more integrated, and that it has incorporated lessons learnt from the pandemic.

The Bill also contains provisions to support social care, public health and quality and safety in the NHS. The Government says these provisions are designed to address specific problems or remove barriers to delivery and to “maximise opportunities for improvement.

What does the Bill do?

Several provisions in the Bill were originally proposed by NHS England, such as establishing existing Integrated Care Systems (ICSs) on a statutory footing, formally merging NHS England and NHS Improvement, and making changes to procurement and competition rules relating to health services.

The Bill also includes proposals from the February 2021 White Paper to give the Secretary of State for Health and Social Care powers to direct NHS England and to decide how some other health services are organised. It gives the Secretary of State powers to transfer functions between some of the ‘Arm’s Length Bodies’ that lead, support and regulate healthcare services in England, and to intervene in proposed changes to the way health services are delivered.

The Bill doesn’t cover wider reforms of the social care and public health systems, although it does provide for some changes in these areas (and ICSs are intended to improve coordination between the NHS and local authority services).

Guidance on submitting written evidence

Deadline for written evidence submissions

The first sitting of the Public Bill Committee is expected to be on Tuesday 7 September. Written evidence can now be sent in to the Public Bill Committee. The sooner you send in your submission, the more time the Committee will have to take it into consideration and possibly reflect it in an amendment. The order in which amendments are taken in Committee will be available in due course under Selection of Amendments on the Bill documents pages. Once the Committee has dealt with an amendment it will not revisit it.

The first sitting of the Public Bill Committee is expected to be Tuesday 7 September and the Committee is scheduled to report by Tuesday 2 November. However, please note that when the Committee concludes its consideration of the Bill it is no longer able to receive written evidence and it can conclude earlier than the expected deadline of 5.00pm on Tuesday 2 November. You are strongly advised to submit your written evidence as soon as possible.

Your submission should be emailed to scrutiny@parliament.uk

Further guidance on submitting written evidence can be found here.

The Long Term Plan

On 7 January 2019 the Government launched the NHS long term plan setting out how the service will develop over the next 10 years.

The plan highlights seven priority areas:

  • cancer
  • mental health
  • care for people with two or more chronic medical conditions
  • support for people to age healthily
  • children’s health
  • cardiovascular and respiratory diseases
  • learning disability and autism

The plan pledges action which will in total prevent 500,000 deaths over the next decade through prevention and early detection of problems. The plan also promises to change the way that patients access health services with increased use of new technology and different ways of accessing help.

Over the next few months the NHS nationally and locally will be publishing details of how it will implement the plan. Other initiatives such as the social care green paper and spending review which are expected later this year will complement the plan.

See www.longtermplan.nhs.uk
King’s Fund – The NHS long-term plan explained

The local plan to cover Portsmouth, Southampton, Hampshire and the Isle of Wight

A summary plan of the proposal that was sent in November 2019 to the Department for Health and Social Care can be found here on the Hampshire and Isle of Wight Sustainability and Transformation Partnership’s website: https://hiowhealthandcare.org/

Other documents that are informing health service planning:

Health Equity in England The Marmot Review 10 Years On full report Feb 2020

We continue to be in discussion with senior decision-makers to seek progress with plans to better communicate and engage with city residents. We are also working with other Local Healthwatch across the Hampshire and Isle Of Wight (HIOW) area to ensure senior commissioners and providers are planning in how to involve the public for issues that impact more than one area, such as access to hospitals, mental health services and primary care.

For more information, you might find the following links useful:

Health & Care Portsmouth

Health and Care Portsmouth has developed a local plan, specific to Portsmouth, which aims to implement key actions and changes to improve the health and well-being of Portsmouth residents.

The five key organisations involved in designing this plan are:

The aim of the local plan is to enable organisations to work closer together with greater emphasis on working in local communities, through the design and provision of all health and care services.

More details about the plan can be found at on the Health and Care Portsmouth website.

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