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Workforce is the biggest barrier to developing ICSs, leaders say

Workforce is the biggest barrier to developing ICSs, leaders say
By Jess Hacker
10 February 2022



More than three-quarters of ICS leaders said that workforce challenges present the greatest obstacles to ICS progress over the coming years, according to the NHS Confederation.

As many as 76% of executive leads and programme directors stated that national workforce shortages were preventing systems from developing further.

The survey – conducted as part of its annual ICS review – saw responses from 35 of England’s 42 ICSs.

Leaders ranked concerns around financing as the second largest barrier (63%), followed by a lack of settlement for social care (57%), and the threat posed by the elective backlog (37%).

The report noted that the NHS entered the pandemic with more than 100,000 vacancies, with gaps becoming ‘entrenched’ across the system as a result.

And while eight-in-10 respondents felt confident they could deliver a ‘one workforce’ approach by July 2022, the Confederation cautioned that expectations must be ‘realistic’.

The approach – which is defined by a workforce drawn from a range of disciplines working across pathways – can only improve working culture so much ‘if such severe shortages continue’, it said.

Similarly, it warned that while a national workforce strategy is a necessity, system level plans will be ‘essential’ to maintain good levels of retention across the sector.

It comes a month after NHS England confirmed the target date to grant integrated care systems (ICSs) statutory footing would be pushed back by three months to July 2022.

Involve primary care leaders in ICBs

Meanwhile, NHS England has been advised to ensure voices from primary care are better represented on Integrated Care Boards (ICBs).

The NHS Confederation recommended that NHSE work with both ICSs and primary care services to develop forums that would allow ‘all primary care leaders across a system’ to feed views to those who sit on the ICB.

Interviews with primary care leaders revealed that in many areas there is an ‘uncertainty’ as to how far their insights help inform system-level planning, it said.

It suggested that NHSE establish ‘clear’ requirements for primary care governance and engagement at place level to build on or replace those lost as CCGs dissolve.

This should include infrastructure support for primary care to better link with the wider NHS.

The review comes a day after the Government published its integration white paper which sets out how it expects ICSs to work more closely with local authorities, social care, and the wider NHS.

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