A robust regulatory mechanism at system – and place level

In our third blog in the series on the Integration White Paper, we look at the proposals on regulation and oversight of the ICS landscape. These build on existing oversight arrangements, some of which are being strengthened through the Health and Care Bill, such as the new duty on the Care Quality Commission to review ICSs as a whole. Broadly, these reviews will look at how system partners are working together to deliver care, along with delivery against shared outcomes.

The White Paper states at the outset that it reinforces the role of robust regulatory mechanisms to support the delivery of integrated care at place. Chapter 3 covers Leadership, Accountability and Finance.

The Paper confirms that CQC will be required to consider outcomes agreed at place level as part of its assessment of ICSs, with the regulator continuing to develop its assessment of individual providers, to ensure their contribution to plans that improve outcomes at place and ICS level are assessed as part of the overall oversight framework.

The Integration White Paper describes CQC’s future role in system regulation explaining that they will consider both the starting position for each ICS and local authority and the local and national priorities each area needs to manage to help understand how those partners are working together to deliver safe, high quality and integrated care. Currently work is in progress to develop the methodology of CQC reviews. NHS leaders will welcome the confirmation that CQC’s work will be complementary to existing oversight and support processes, including those used by NHS England to support ICSs.

Ensuring we have the right regulatory frameworks in place to assess levels of integration and partnership working is complex given the layers of accountability within an ICS, from Integrated Care Boards to Integrated Care Partnerships, providers and local authorities – not forgetting the interplay between local and national priorities. Evaluating these metrics against locally defined outcomes is key to the public understanding the performance of its local health and care system.

You can read our earlier blog on digital and data here and our overview of the Integration White Paper here.

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