The challenges ahead for delivering integrated care

Serious effects from the pandemic still affect the NHS, and may be felt for a few years to come, hospitals and staff are under extreme strain, the backlog of unmet needs is growing and there is a major reorganisation being undertaken. It is no wonder that the effect is clear for everyone to see.

NHS England is driving the changes towards better integrated care, as it fervently believes that joined up care serves people better than the current fragmentation. Local partners which include the NHS, councils, the voluntary sector and others, when working together, are capable of creating better services, based on local need. In July 2022, the framework of Integrated Care systems (ICSs) was set up to make this work. Their key aim is to improve health and care services focusing on prevention, better outcomes and reducing health inequalities. They have arrived in the middle of a cost-of-living crisis, which is affecting the poorest people in the country — those who perhaps are the key people who the ICSs are aiming at.

Aside from the challenges which the NHS alone faces, there is enormous budgetary stress in many of the local authorities who are having to make substantial cuts to services. The cost-of-living crisis is having a profound impact on people's mental and physical health, exacerbating their health needs and increasing demand for services. Many of the food banks which have been set up over the last few years are now having their grants cut,¹ so that the social infrastructure and food parcels look in extreme danger of having to be stopped unless other sources of income can be found. This would only increase the vulnerability of a very vulnerable population.