Integrated care systems could have two leadership boards

A draft white paper, seen by HSJ, said the Department of Health and Social Care accepts proposals to make ICSs statutory bodies.

It says they would be made up of an NHS board as well as a separate “health and care partnership”.

The NHS board would be responsible for planning, financing and commissioning of health services, and would include trust chief executives, GPs, and local authorities, in a similar vein to what many systems have started to operate.

The paper says the NHS boards will take over commissioning functions from clinical commissioning groups and some from NHSE within their geographic boundaries.

It adds: “Each ICS NHS body will have a board, and this will be directly accountable for NHS spend and performance within the system, with its chief executive becoming the accounting officer for the NHS money allocated to the NHS ICS Body.

“The board will, as a minimum, include a chair, the CEO, and representatives from NHS trusts, general practice, and local authorities, and others determined locally.”

Meanwhile, the separate HCP boards “will be responsible for developing a plan that addresses the wider health, public health, and social care needs of the system”. The ICS and local authorities “will have to have regard to that plan when making decisions”.

The paper says it was convinced of the need for the HCP boards after discussions with the Local Government Association and other bodies.

It is not clear who will be members of the new HCP boards or what other role it will play. The white paper says it could include health and wellbeing boards, Healthwatch, voluntary organisations, social care providers and independent sector partners.

But it adds: “We do not intend to specify membership or detail functions of the new partnership. Local areas can appoint members and delegate functions to it as they think appropriate.”

Other changes

NHS providers will retain their current organisational financial duties but will have to abide by a “new duty to compel them to have regard” for system finances. It is not clear what mechanisms will be in place to stop these two legal duties from conflicting with each other.

In a significant shift, DHSC wants powers to “require” NHSE to accept some public health functions after Public Health England is abolished.

The white paper also confirms health services will no longer be subject to competition and procurement legislation except for the procurement of “non-clinical services, such as professional services or clinical consumables”.

To answer concerns the NHS will no longer be able to ensure value for money if it does not tender contracts, DHSC said it will “create a bespoke health services provider selection regime”.

The DHSC declined to comment on leaked documents.