The head of NHS England has pledged to end the “fractured” health and social care system by giving local leaders and communities more control over how they improve it.
Addressing the NHS Confederation in Liverpool, Simon Stevens said: “As the NHS approaches its 70th Birthday, we are now embarked on the biggest national move to integrating care of any major western country. For patients this means better joined up services in place of what has often been a fragmented system that passes people from pillar to post.”
He announced nine areas in England – covering some seven million people – which will be the forefront of nationwide action to provide joined up, better coordinated care breaking down the barriers between GPs and hospitals, physical and mental healthcare, social care and the NHS.
Eight ‘accountable care systems’ (ACSs) will bring together local NHS organisations, often in partnership with social care services and the voluntary sector. They build on the learning from and early results of NHS England’s new care model ‘vanguards’, which are slowing emergency hospitalisations growth by up to two thirds compared with other less integrated parts of the country.
The first group of designated ACSs have agreed with national leaders to deliver fast track improvements set out in Next Steps on the Five Year Forward View, including taking the strain off A&E, investing in general practice making it easier to get a GP appointment, and improving access to high quality cancer and mental health services.
These areas will also lead the way in taking more control over funding available to support transformation programmes – with the combined indicative potential to control around £450m of funding over the next four years – matched by accountability for improving the health and wellbeing of the populations they cover. NHS national bodies will provide these areas with more freedom to make decisions over how the health system in their area operates.
The announcement also includes a new devolution agreement in Surrey Heartlands, similar to the existing one in Greater Manchester. This agreement will bring together the NHS locally with Surrey County Council to integrate health and social care services and give local leaders and clinicians more control over services and funding.
The eight accountable care systems are:
- Frimley Health including Slough, Surrey Heath and Aldershot
- South Yorkshire & Bassetlaw, covering Barnsley, Bassetlew, Doncaster, Rotherham, and Sheffield
- Nottinghamshire, with an early focus on Greater Nottingham and Rushcliffe
- Blackpool & Fylde Coast with the potential to spread to other parts of the Lancashire and South Cumbria at a later stage
- Dorset
- Luton, with Milton Keynes and Bedfordshire
- Berkshire West, covering Reading, Newbury and Wokingham
- Buckinghamshire.
In addition, it is expected that West, North and East Cumbria and Northumberland could join the group of accountable care systems later in the year.
The announcement came as NHS England medical director Professor Sir Bruce Keogh told the conference: “We need to heal fractures between services and tear down those administrative, financial, philosophical and practical barriers to the kinds of services our patients want us to deliver. To get there, we must replace the fear of change with convincing arguments for the future – or I for one worry that risk weakening our greatest social asset through inaction or fatigue.”
