Where we begin our story
In July our Integrated Care Partnership (ICP) was formally established. This is a statutory committee that brings together a broad set of system partners (including local government; the voluntary, community and social enterprise sector; NHS organisations; and wider partners) to work together to plan and deliver joined up health and care services.
One of the first requirements of our ICP is to develop an integrated care strategy for north east London (NEL).
Our partnership brings huge potential to work together as a system towards a much greater focus on population health outcomes and tackling inequalities. However, it is important to recognise and acknowledge the challenging context many parts of our system are facing at this point in time as we come together as a partnership to develop our new integrated care system.
Our ICP serves one of the most deprived populations in the country where poverty and inequalities are stark. Our population is under increasing pressure in the wake of the recent COVID-19 pandemic which exacerbated health inequalities and brought longer term impacts to the physical and mental health and wellbeing of local people, impacting individuals, households and communities in ways that are still not fully understood. In addition, we know that the cost of living is further impacting local people, the majority of whom (70%) have told us they are currently struggling in one or more aspects of daily life, be that in their health, housing, income, food or with loneliness.
Furthermore, these challenges are set to grow as unprecedented population growth continues to redefine our communities over the coming decades, and the health and care needs of local people continue to increase in complexity as our overall population ages.
Our health and care workforce is the linchpin of our system and central to every aspect of this strategy. However, the challenges currently facing health and social care staff, teams and organisations working in NEL cannot be underestimated. Services are seeing extreme winter pressures with unprecedented demand for care, particularly urgent care, from our population. There is huge demand for planned care which was so heavily impacted by the pandemic, with an urgent need to address long waiting times and inequity. A high number of vacancies is placing a greater burden on our staff, increasing stress and burnout. This is coupled with an additional challenge of managing the impact of industrial action.
These huge challenges create a ‘burning platform’ for action as an integrated care system – we cannot continue to work in the same way, doing the same things. Partners in NEL are clear that we need a radical new approach to how we work as an integrated care system to tackle the challenges we are facing today as well as securing our sustainability for the future.
This strategy is intended to provide the framework for our partnership to do that. It does not provide all the answers or reference the full range of work we will need to do to achieve our ambitions. It signs us up as a partnership to a clear set of priorities, core themes for working differently and some key foundations for our system.
NEL Integrated Care Strategy in a nutshell
Partners in NEL have agreed a collective ambition underpinned by a set of design principles for improving health, wellbeing and equity.
To achieve our ambition, partners are clear that a radical new approach to how we work as a system is needed. Through broad engagement including with our health and wellbeing boards, place based partnerships and provider collaboratives we have identified six cross-cutting themes which will be key to developing innovative and sustainable services with a greater focus upstream on population health and tackling inequalities.
We know that our people are key to delivering these new ways of working and the success of all aspects of this strategy. This is why supporting, developing and retaining our workforce, as well as increasing local employment opportunities is one of our four system priorities identified for this strategy.
Stakeholders across the partnership have agreed to focus together on four priorities as a system. There are of course a range of other areas that we will continue to collaborate on, however, we will ensure there is a particular focus on our system priorities and have been working with partners to consider how all parts of our system can support improvements in quality and outcomes and reduce health inequalities in these areas.
We recognise that a well-functioning system that is able to meet the challenges of today and of future years is built on sound foundations. Our strategy therefore also includes an outline of our plans for how we will transform our enabling infrastructure to support better outcomes and a more sustainable system. This includes some of the elements of our new financial strategy which will be fundamental to the delivery of greater value as well as a shift in focus ‘upstream’.
Critically we are committed to a relentless focus on equity as a system, embedding it in all that we do.