Accountable and integrated care: new ways of working for the NHS

The NHS needs to work differently. Constraints on NHS funding combined with rising demand on services from a growing and ageing population have put the NHS under significant pressure.

Nationally, and locally, there are plans to work in a different way, providing more care in people’s home and the community, and breaking down barriers between the many organisations that are working to look after people and their health.

This means bringing together and coordinating the work of GP practices, community services and hospitals to meet the needs of people requiring care, especially for those who have several medical conditions and who receive care and support from a variety of health and social care staff.

Integrated care like this happens when NHS organisations work together to meet the needs of their local population.

Different forms of integrated care

The development of integrated care is taking different forms in different places in the country, and a variety of terms are being used:

  • Integrated care systems (ICSs) – these are groups of NHS providers and commissioners and local authorities, working together to improve health and care in their area;
  • Integrated care partnerships (ICPs) – these are alliances of NHS providers working together to deliver care by agreeing to collaborate rather than compete. These providers include hospitals, community services, mental health services and GPs. Social care and independent and third sector providers may also be involved;
  • Accountable care organisations (ACOs) – established when commissioners award a long-term contract to a single organisation to provide a range of health and care services to a defined population. This organisation may subcontract with other providers to deliver the contract.

Integrated care systems (ICSs) have been established in ten areas in the country including Greater Manchester and Surrey Heartlands, and integrated care partnerships (ICPs) are at various stages of development.

Consultation on accountable care

There are concerns that accountable care contracts could allow private companies to take a bigger role in healthcare if they decide to enter the market and bid for contracts.

In response to these concerns, NHS England has decided to delay the use of the proposed accountable care contract and Secretary of State, Jeremy Hunt announced that there will be a consultation on the creation on accountable care organisations (ACOs) to understand the details of exactly how ACOs will work, including the contract terms involved.

Local plans

Originally as part of local plans for how the NHS should work differently in Coastal West Sussex (plans called Coastal Care), the local NHS talked about an intention to form an accountable care partnership.

However, the local intention is to bring current providers and commissioners together, working in a new way, not to go through a procurement process for a new contract. Therefore, what our plans really refer to is integrated care rather than accountable care.

Local leaders of the NHS believe that integrated care is the right thing to do for local people and those working in the NHS, and are working together to move these plans forward.

Further reading

You can read more about the plans for integrated care in Coastal West Sussex on the Coastal Care page on the CCG website.

You can also read more about integrated care systems, integrated care partnerships, and accountable care organisations on the King’s Fund’s website.