Gaps in Bill question level of local control

A major gap in the government’s controversial Health and Care Bill is the lack of any guarantee of much more local “place based” decision-making and planning of services to meet the needs of local communities within much wider “Integrated Care Systems” (ICSs).

The Bill would put just 42 ICSs in control of the NHS across England – several of them covering populations of over 2 million.

The largest, with over 3.2m population, is the most northern ICS (North East and North Cumbria) which will cover from coast to coast – Carlisle to Newcastle, and from Whitby in the south to the Scottish border – an area and population so large and unwieldy that the ICS website manages to avoid displaying a map, listing the 17 councils covered, or any mention of the size of the ICS population.

Four more ICSs have populations of 2 million or more – Greater Manchester, West Yorkshire, Cheshire & Merseyside and North West London.

By contrast 16 of the 42 ICSs have populations of less than 1 million, and three have just 500,000 – Somerset, Cornwall and Shropshire and Telford & Wrekin. But even in the smaller ICSs there are distinct differences between more local “places” within the ICS area.

Full story in The Lowdown, 20 September 2021