The 2019 NHS Long Term Plan commits to the further development of Integrated Care Systems (ICSs), with ICSs to cover all of England by April 2021. ICSs bring together local organisations in an effort “to redesign care and improve population health, creating shared leadership and action”, seeking to deliver the “triple integration of primary and secondary care, physical and mental health services, and health with social care”. Against this background, it will be crucial to better understand the challenges facing the (further) development of innovative delivery systems such as ICSs, and to identify ways to address them. There is a need to explore the key factors that promote (or hinder) the establishment of shared leadership and action locally as envisaged for ICSs, recognising that these will vary across local systems, and to identify the core elements acting at the different tiers of the system, and their interrelationships, that effectively and sustainably support the implementation, sustaining, spreading and, where appropriate, scaling of service innovations such as ICSs, especially in the most potentially difficult settings.
This project will contribute to advancing our understanding of these complex issues by exploring the experiences of a selected set of countries in Europe that have introduced similarly innovative delivery systems that seek to bring together health and social care locally. Cross-country policy research offers opportunities to examine similar challenges using the lens of different system contexts to identify the key components, mechanisms and factors that are involved in service innovation and that may then inform health and care policy in England. Our focus is on understanding the policy processes that are involved at the different tiers of the system, and to explore the nature and role of different contextual (regulatory, administrative, financial, cultural) factors in embedding new ways of working into the care process. Our ultimate aim is to expand the range of (policy) options for health and care leaders in England to effectively implement innovative delivery systems with similar ambitions.
A second phase of this project was recently funded by the NIHR PRP Programme (Recovery, Renewal, Reset: Research to inform policy responses to COVID-19 in the health and social care systems). Phase II will be completed in December 2021, and will provide a longitudinal view of the impact of COVID-19 on innovations in service organisation and delivery in our Scottish, Dutch, and Italian case studies.