26 January 2023

The RCSLT has made recommendations to the Hewitt Review of Integrated Care Systems (ICSs).

The RCSLT has responded to the Hewitt Review’s call for evidence on ICSs.

We are pleased that the call for evidence recognises the need to improve population health and healthcare outcomes and tackle inequalities and access.

Integrated Care Systems

On 1 July 2022, ICSs were placed on a statutory footing through the creation of integrated care boards (ICBs), which are statutory NHS bodies, and integrated care partnerships (ICPs), which are joint committees formed by each ICB and the relevant local authorities in the ICS area.

ICSs bring together the NHS, local government, the voluntary, community and social enterprise (VCSE) sector and other partners to better integrate services and take a more collaborative approach to agreeing and delivering ambitions for the health and wellbeing of their local population.

Our key messages to the review

  • ICSs are still very new. They need time to bed down before there is any chance of increasing innovation. The top-down expectation for this is unrealistic and could have the opposite effect, impacting adversely on staff morale, engagement and retention.
  • Performance improvement should be driven through supportive mechanisms such as peer support and peer review.
  • The new duties in the Health and Care Act requiring ICBs to specifically consider the needs of children and young people have considerable potential, if implemented meaningfully, to enable ICSs to achieve their goals. It is imperative that any potential recommendations of the Hewitt Review build on, rather than undermine, the emphasis the Health and Social Care Act placed on babies, children, and young people within the ICS statutory framework
  • As an Allied Health Profession (AHP), difficulties are being felt by speech and language therapy services because there is no mandatory AHP representation on ICBs. There is in many cases no seat at the table to represent the roles of one third of the NHS workforce.
  • A strategy to tackle the lack of workforce planning, national assessment of demand and unmet needs leading to a shortage in AHP professionals, as local levels fail to take account of professionals employed by non-health employers, such as those working in independent practice, schools and employed by the NHS but working in non-health settings.
  • RCSLT are calling for all ICS/Bs to support services in addressing health inequalities and unmet needs in their areas. The RCSLT health inequalities resource and audit tool has been produced to support speech and language therapists to address health inequalities in their practice.

Next steps

The RCSLT looks forward to working with the Hewitt Review team, the Department of Health and Social Care and other partners as the report and its recommendations are further developed, as well as on improving access to speech and language therapy for all.

Read our response in full (PDF)

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