Council supports the recommendations in the Hewitt Report

The Rt Hon Patricia Hewitt published her independent review this month, setting out how oversight and governance of integrated care systems (ICSs) can best enable them to succeed.

“Integrated Care Systems,” she describes in her review, “represent the best opportunity in a generation for a transformation in our health and care system.”

They bring together the NHS, local government, social care providers, voluntary, community, faith and social enterprise sectors, in a common purpose to improve people’s health and healthcare.  We have an integrated care system in Devon, that we, NHS Devon, and others are part of.

In her review, known as the Hewitt Review, Patricia Hewitt proposes changes that she believes would improve the way that integrated care systems support the health of the population in their local communities.

She recommends that ICSs should be able to focus more than they do currently on prevention and promoting good health, rather than on treating illness.

She proposes more funding, from the NHS budget at ICS level, to be available for the purpose of prevention.

She also says that national and regional organisations should support ICSs in become ‘self-improving systems’, and that national Government and NHS England should ‘significantly’ reduce the number of national targets and national priorities to allow good local leadership with greater autonomy.

And, she says, what’s needed is to ‘pull down some of the barriers that currently exist for primary care, social care and the way we train health and care workforce’, arguing for a social care workforce strategy, and that more should be done to enable flexibility for health and care staff moving between roles and in the delegation of some healthcare tasks.

On the way that healthcare is funded, she says, “NHS funding remains over-focused on treatment of illness or injury rather than prevention of them, and ICS partners struggle to work around over-complex, uncoordinated funding systems and rules in order to shift resources to where it is most needed.”

Instead, she says, there should be a more effective funding model that will incentivise and enable better outcomes and significantly improve productivity.

It’s up to the Government now to respond to the Hewitt Report’s recommendations.

Devon County Council this week published its reaction to Hewitt Report.

“We support the recommendations in the Hewitt Report, and as the County Councils Network and the Association of Directors of Adult Social Services have done, we welcome a greater focus on prevention and population health with Integrated Care Systems, and the helpful reminder and recognition of the role children’s social care has in Integrated Care Systems.

“We particularly welcome the recommendation to increase NHS prevention funding at the ICS level by 1 per cent over five years, acknowledging that prevention is not given the necessary priority across the system.

“With our roles and expertise in Public Health and our approaches across Adults and Childrens Services to early help, enabling, and promoting independence we have a lot to offer in this space.

“We do however urge Government to ensure that local authorities are funded sufficiently to support our vital work in supporting those in most need, and to be able to invest in the preventative services and opportunities now, and in the longer term, for people across all stages of their life in neighbourhoods and communities across our areas.   

“We welcome the recommendation that Government develops a social care workforce strategy to complement the workforce plan being developed for the NHS. This is long overdue across a sector that is experiencing long standing sufficiency challenges.

“Again, investment in the social care workforce is vital and we urge Government to make this a priority.

“We welcome the recommendation that local authority scrutiny committee should have an explicit role as system overview and scrutiny committees. Across Devon we have a history of local authority scrutiny committees, and Health and Wellbeing Boards, coming together as a collective to work on areas of commonality. We hope to be able to build on this further.”

The government is now considering the recommendations made by the review.