The must-read stories and debate in health policy and leadership.

The government is planning to introduce a new crucial distinction between different entities in the acronym soup that is the integrated care agenda.

The draft health and care bill expanded the flourishing crop of three-word terms with integrated care boards and integrated care partnerships, which will sit atop integrated care systems and their constituent partnerships, collaboratives and networks.

ICBs will be the NHS body responsible for NHS contribution to the ICS. The ICP will be where the ICB and other non-NHS partners in the health system, such as local government, come together.

Last week health minister Edward Argar introduced the new ICBs and ICPs to the vexed issue of the involvement of private interests in the running of NHS health systems.

There is considerable anxiety in parts of Westminster and beyond that representatives of private companies will be allowed to occupy seats on boards that run integrated care systems. Some are worried the ICSs will be avenues through which greater privatisation will flow.

Mr Argar sought to quell concerns, telling MPs during a debate about the new bill that the government would introduce an amendment “to protect the independence of ICBs by preventing individuals with significant interests in private healthcare from sitting on them”.

However, he said the government will not extend the same prohibition to the ICP.

“We would expect members of the ICP to be drawn from a very wide variety of sources and backgrounds,” he said. “To exclude independent providers from both the ICB and the ICP would, I fear, risk severely reducing the extent to which all parts of the broader health and care ecosystem could be drawn upon in the ICP context.”

Identifying ‘weaknesses in culture’

What does it mean for a service to have “weaknesses in culture”?

An independent review of maternity services at Sandwell and West Birmingham Trust has said there was evidence of weaknesses due to a number of issues. These included: some poor behaviours of staff going unaddressed, lack of strong and visible leadership and the finding that some staff have a fear of ‘speaking up’.

Interestingly this external review was finalised in the same month the Care Quality Commission inspected the trust’s maternity services. The regulator’s scrutiny was prompted by whistleblower concerns. However, the CQC’s final inspection report paints a more positive picture and it rated the service “good” overall and “good” for well led.

While concerns raised in the independent review shouldn’t preclude the CQC giving the trust a good rating, it does raise concerns. One midwife speaking to HSJ said staff were “devastated” by the CQC conclusions and would not have minded if the service had got special measures as long as staff got help. Two other staff members raised concerns about the CQC’s rating.

It is not yet clear how deep the issues at Sandwell and West Birmingham go. However, for three staff members to be “devastated” by a positive rating suggests issues raised by the independent review are not yet resolved.