Integrated Care Systems final report published

2 September 2022

Summary

The aim of our research was to investigate the development of Integrated Care Systems (ICSs) in order to find out how effective these new forms of collaboration are in achieving their goals, and what factors influence this. The research investigated how ICSs were developing locally, the way system partners were reconciling organisational and system roles, how collaborations and providers could be held to account, the way local priorities were being reconciled with system priorities, and whether ICSs are able to allocate resources more efficiently across sectoral boundaries and bring their local health economies into financial balance.

Our research was conducted in two phases and used qualitative methods with a small quantitative component. Primarily, we used a case study research design, consisting of three in-depth case studies, each consisting of a system and its partners. The first phase of fieldwork was undertaken between December 2019 and March 2020 and focused on studying ICSs (and their predecessor STPs). Fieldwork was interrupted in March 2020 by the COVID-19 pandemic. The second phase of fieldwork took place between January 2021 and September 2021 and focused on a more detailed examination of one place within each of our case studies.

Our research suggests that the move to a more collaborative ethos has been welcomed, and system partners widely support the development of system working, and the opportunities for improved planning and provision of services which they believed system working offers. Local actors felt that collaboration in systems led to improvements to service planning and delivery in ways that did not occur previously. However, our findings also suggest that there are a number of key themes which need to be considered in relation to the capacity of systems to achieve their aims, including bringing their local health economies into financial balance. These are: the ongoing influence of competition; the importance of context; clarity of governance arrangements; limits of the consensual model of decision making; the development of accountability; and management of conflicts of interest.

Download full report: The Developing Architecture of System Management: Integrated Care Systems and Sustainability and Transformation Partnerships.