White paper’s clarion call to ICS leaders to engage with adult social care sector

Research outlined in a white paper finds that effective engagement among Integrated Care Systems or ICSs with the adult social care sector (ASC) has not been consistent.

Through a series of interviews and a virtual round table event held by the Good Governance Institute with Care England and the Homecare Association, ICS leaders and representatives from ASC providers across the country explored the extent to which the sector was being engaged with the ongoing development of ICSs.

The research findings confirm “a very clear divide in terms of the perceptions of the NHS and ASC sector” which the report explained is “primarily due to the differences in economic models of the two systems”. Overall, the research found that “very few ICS leaders knew much about social care at all” with social care often being treated as an “afterthought compared to the rest of the health and social care system”.

Emerging themes

Several key themes emerged from the research which highlight the complexity and challenges around ICS and ASC engagement and collaboration. One of the most challenging aspects in terms of engagement with ASC sector is that ICSs are still relatively new, said the white paper. The new Health and Care Act puts ICSs on a statutory footing from July 2022, with each ICS made up of two bodies: an integrated care board (ICB) and an integrated care partnership (ICP).

From the research findings, many representatives from ICSs are keen to achieve more detailed engagement with the sector but the process is likely to be “slow”, with the following consistent issues raised during interviews:

• Representation of the ASC sector within ICS
• Workforce issues, covering employee retention, career progression, staff skills and training
• Care service experiences
• Digital innovation in the ASC sector

While the paper concludes that the profile of the ASC sector has grown, it says that there remains a lot to be done, with some places seeing the sector teetering on the edge of “implosion”. However the paper explains that “there is an opportunity for ICSs to work with ASC providers and commissioners to develop plans to secure the sustainability of services in their areas”.

“A stable ASC sector is critical to a good ICS”

The paper makes five recommendations to improve engagement with the sector:

• ICSs are asked to note that the social care partner member on the Integrated Care Board will not necessarily be able to effectively represent providers, and therefore, ICSs should work with providers to develop more effective engagement mechanisms.
• ICSs should develop a plan about how to engage with ASC providers and involve them in the process.
• ICSs should have a provider forum or liaise with local care associations which nominates a representative to the ICS Partnership Board.
• ICSs should ensure that ASC providers have a role in the new local place arrangements, the Integrated Care Partnership and/or the ICB. Perhaps through the creation of a paid position that is tasked with furthering the ASC agenda and educating others around them on the issues facing the sector.
• The Department of Health and Social Care publish a specific framework for ICS engagement with the ASC sector.

Andrew Corbett-Nolan, CEO of GGI, said: “Engagement with adult social care is essential to the success of integrated care systems (ICSs) and the development of health and social care services. This paper comes at an essential time for engagement with key partners across the system, to enable connections between health and social care.”

Martin Green, CEO of Care England, said: “In order for ICSs to succeed, social care providers must be heard. We urge all ICS leaders to carefully consider the key recommendations in this paper to ensure that integration works for both health and social care.”