ICS resets decision making to accelerate ‘new model of care’

Sussex Integrated Care Board set out the proposals in a paper on how it will implement its strategy and respond to worsening finances.

The new structure will bring about “accelerated development of a new model of collaborative care in NHS community and acute services”, it says, including “transfer[ring] services and appropriate funding to the new community model”.

The system has not so far settled the shape of its provider collaboratives, and the paper says there will be two: one for acute services and another for community services (including primary care).

The community collaborative will “design a core NHS community model of care” to be standardised across 16 integrated community teams, which match district and borough councils where they exist.

“This is a significant change for the system and indicates that the NHS and local government organisations have committed to work in a fundamentally different way to integrate care and improve population health,” the paper says.

The acute collaborative will design a “model of care… to ensure we have evidence-based acute pathways as we transfer services and appropriate funding to the new community model”.

The ICB will also “restate the joint commissioning arrangements” with its three top-tier local authorities and plans a “refresh of the partnership executives” for each of these three places.

The ICB will become a “strategic commissioning organisation” and therefore move transformation staff and resources to “the provider sector in their collaborative form”.

It comes as ICBs are required to make big cuts to their running costs by April 2025, but HSJ understands the staff transferring to provider collaboratives will come on top of those reductions. 

The ICB will, however, chair a new committee-in-common which will include all its NHS providers, to oversee the work. 

The paper is from ICB CEO Adam Doyle who also works part-time as NHSE national director for system development, and is due to be discussed by the ICB’s board this week.

The ICS is forecasting it will break even in 2023-24, but has a £155m “unmitigated financial risk” for this year, equivalent to 5.3 per cent of income. The paper says: “We will not be able to resolve the size of the financial challenges without our organisations working together in a fundamentally different way…

“All NHS organisations have also agreed that the current model of care delivery is not affordable or sustainable in its current form.

“As a result, a revised financial sustainability and productivity programme will be established and overseen through a… committee-in-common approach across all our NHS trusts and the ICB.”

Seven CCGs in Sussex were merged into three in 2019, before the transfer into a single ICB last year.