دمج الرعاية: الخطوات التالية لبناء أنظمة صحية متكاملة قوية

Integrating care Next steps to build ing strong and effective integrated care systems across England 1 | Contents Contents مقدمة ................................ ................................ ........................ 2 Purpose ................................ ................................ ............................. 4 Putting this into practice ................................ ................................ ... 9 Legislative proposals ................................

1. 1. The الخدمة الصحية الوطنية belongs to us all1 and any changes to it must bring clear improvements for our health and care. Since 2018, integrated care systems (ICSs) have begun doing just this, enabling الخدمة الصحية الوطنية organisations, local councils, frontline professionals and others to join forces to plan and p rovide around residents’ needs as locally as possible. 1.2. By doing this, they have driven a ‘bottom -up’ response to the big health and care challenges that we and other countries across the world face and have

• distribution of financial resources to places and sectors that is targeted at areas of greatest need and tackling inequalities; • improvement and transformation resource that can be used flexibly to address system priorities; • operational delivery arrangements that are based on collective accountability between partners; • workforce planning, commissioning and development to ensure that our people and teams are supported and able to lead fulfilling and balanced lives; • emergency planning a

1. 1. There are many good examples of recent system working that have improved outcomes and productivity, and helped to address inequalities. But COVID has made the case for a step up in scope and ambition. The الخدمة الصحية الوطنية and local government are increasingly pressing for a more driven and comprehensive roll -out of system working. 2.2. So, in this section we set out a series of practical changes which will need to be in place by April 2022 at the latest, to make a consistent transition to system workin

1. 3. We will support preparatory work during 2021/22 with further guidance for systems and in the الخدمة الصحية الوطنية Operational Planning التوجيه for 2021/22. Provider collaboratives 2.4. Provider organisations will play an active and strong leadership role in systems. Through their mandated representation in ICS leadership and decision -making, they will help to set system priorities and allocate resources. 2.5. Providers will join up services across systems. Many of the challenges that systems face canno

i. the configuration, size and boundaries of places which should reflect meaningful communities and scale for the responsibilities of the place partnership; ii. additional membership of each place partnership that is likely to include acute providers, ambulance trusts, the voluntary sector and other partners; iii. the precise governance and decision -making arrangements that exist within each place; and iv. their voting arrangements on the ICS board. • provider collaborative leadership arrange

i. the scale and scope of provider collaboratives. For smaller systems, provider collaboratives are likely to span multiple systems and to be represented on the boar d of each. These arrangements should reflect a meaningful scale for their responsibilities; ii. the precise membership of each collaborative (acute providers, specialist providers, ambulance trusts at an appropriate footprint, mental health providers); iii. the precise governance and decision -making arrangements that exist within e

iii. Any lead provider responsibility that the organisation holds on behalf of a place partnership or a provider collaborative. 2.32. Integrated care systems draw their st rength from the effectiveness of their constituent parts. Their governance should seek to minimise levels of decision -making and should set out defined responsibilities of organisations, partnerships at place, provider collaboratives and the core ICS role. Each ICS should seek to ensure that all the relevant bodies feel own

1. 1. The detailed policy work described above will be necessary to deliver our vision but will not by itself be sufficient. While legislation is only part of the answer, the existing legislation ( the National الصحة الخدمة Act 2006 and the الصحة and Social Ca re Act 2012 ) does not present a sufficiently firm foundation for system working. 3.2. In September 2019, الخدمة الصحية الوطنيةEI made a number of recommendations for an الخدمة الصحية الوطنية Bill2. These aimed to remove current legislative barriers to integration across h

steps 4.1. The ambitious changes set out here are founded on the conviction that collaboration will be a more effective mechanism for tran sformation against long term population health priorities and also for driving sustainable operational performance against the immediate challenges on quality, access, finance and delivery of outcomes that make a difference to people’s experience of servic es today. 4.2. International evidence points to this being the case as across the world health systems c