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Hold ICBs accountable for outcomes not targets, MPs told

Hold ICBs accountable for outcomes not targets, MPs told

By Jess Hacker
8 November 2022

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ICBs must be held accountable for their outcomes rather than be assessed against mass targets, MPs have been told.

The Health and Social Care Select Committee today (8 November) heard that ICBs would benefit from being assessed against a smaller number of outcomes, as opposed to being held against a ‘one-size-fits all’ slew of targets.

In the first hearing for the inquiry into ICS accountability and autonomy, Patricia Hewitt, chair of Norfolk and Waveney ICB and former health secretary, said that NHS England and the Department of Health and Social Care must now steer away from ‘micromanagement and multiple targets setting’.

She said: ‘Hold us – the ICB as the NHS part of the wider partnership –  accountable from the centre for outcomes, rather than micromanage each bit. Imposing a one-size-fits-all approach destroys the unique opportunity statutory ICSs have to do things differently.’

This might include questioning whether patients are reporting better treatment, or whether a footprint has seen a real reduction in ambulance queues or delayed discharges, she said.

Ms Hewitt, who is also deputy chair of the Norfolk and Waveney ICP added that greater freedom and accountability nationally for ‘a limited set of outcomes’, would in turn free up the ICB to address local problems.

Also during the hearing – which was the first to be chaired by Steve Brine, replacing Jeremy Hunt – MPs were warned that the NHS has a fundamentally different sense for accountability than local governments understand.

Councillor David Fothergill, chair of the Local Government Association’s Community Wellbeing Board, said that the system must recognise the local authority arm of the ICS has ‘very different’ accountabilities to the health and care sector.

‘Those of us that stand for public election know what accountability is at a very sharp end and I’m afraid that the accountability to the NHS from an outsider’s perspective seems to be upwards rather than outwards,’ he said.

He clarified that local authority ‘ultimately is responsible to its population’ and that the ICS must factor that difference into its performance.

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