Transfer to integrated care systems could be delayed by six months

The date when integrated care systems (ICSs) go live could be delayed by between three and six months, according to HSJ, which has seen NHS England scenario planning document.

The document says that a decision to delay by three or six months will be made by 15 January. It sets out four potential scenarios for launch:

• 1 April 2022. This is the baseline date.
• 1 April 2022 with a short delay. In this scenario: “The programme continues to work towards a transition date of 1 April but this ultimately becomes unachievable, leading to a short, unplanned delay of up to one month”.
• 1 July 2022
• 1 October 2022

Several ICS leaders told HSJ they were concerned about the tight timetable for implementation. One told the publication that going live in October would allow more time for preparation. Another said that there was a risk attached to going live part way through the financial year, while a delay of a year could mean the ICS policy loses momentum.

The document apparently does not make it clear which option, if any, is preferred by NHS England. In the meantime, officials are still asking local managers to continue to prepare for an April 2022 changeover.

When ICSs come into force, clinical commissioning groups (CCGs) will be abolished. The aim of ICSs is to create joined up care between local authorities, GP practices and hospitals.

Reforms to social care are controversial

The Health and Care Bill, which will bring ICSs into being, is making slow progress through parliament. It has only just entered the Lords phase of its passage. Some parts of the bill are controversial and, if the Lords amend it, it will go back to the House of Commons for consideration. The controversy largely relates to the reforms to social care funding, and the recent decision not to include local authority contributions in the £86k cap on care payments. Some MPs felt the change had been rushed through. Mel Stride, chair of the treasury committee, said: “I do believe that these measures should have been better ventilated in this House, certainly at committee stage, if not earlier.”

Normally there is a lengthy period of time – up to a year – between a bill being passed and being implemented. Once the Health and Care Bill is passed, there will be only a short time in which to complete governance, legal and staffing changes.

An NHS England spokesperson told HSJ: “As everyone knows, we are aiming for 1 April 2022 and that is what ICSs should plan for and expect.”