Integrated Care Systems... What do they mean for Dentistry?
Some more three letter acronyms you might have heard being used more in dentistry... Integrated Care Systems (ICSs) and Integrated Care Boards (ICBs). But what are they and what is their relevance in dentistry?
What is an Integrated Care System?
ICSs are partnerships that bring together NHS organisations, local authorities and others in an area to take collective responsibility for the planning of services to improve health in their area. There are 42 ICSs across England.
Following the Health and Care Act in 2022, ICSs were formalised as legal entities and they have 2 components:
1. Integrated Care Boards (ICBS) - they are responsible for planning and funding most NHS services in the area
2. Integrated Care Partnerships (ICPs) - they are committees that bring together partners including local government, the voluntary, community and social enterprise sector (VCSE), NHS organisations and others to develop a health and care strategy for the area.
The aims of ICSs include:
- Improving outcomes in population health
- Tackling inequalities in outcomes, experience and access
- Enhancing productivity and value for money
- Helping the NHS support broader social and economic development
What does this mean for Dentistry?
ICSs have taken on most commissioning responsibilities for the NHS including from Clinical Care Groups (CCGs) and NHS England and Improvement. Prior to April 2023, NHS dentistry was commissioned directly by NHS England, but now it will be the ICSs responsibility through their ICB.
The new systems are working towards a new model of commissioning, where systems talk to each other in an area and the focus is on collaboration, not competition. The people who worked within NHS dental commissioning within NHS England are now under the ICB and there might be changes while the new structure settles and an ICB in an area takes time to understand their role, the needs of their population and what is currently going on, but this doesn't mean that things will change overnight.
This will open up opportunities to ensure oral health is heard among healthcare... something that doesn't happen very well at the moment. ICBs will be able to hear how access to dental care or oral health problems impact wider health and social care issues; for example, if there is lack of accessible out of hours dental care, when patients turn up to A&E departments with dental pain, increasing pressures in secondary care and A&E waiting times, the ICB will not only recognise this impact, but be accountable for it and be able to address it (hopefully!).
In the short term, it means that new people and new systems need to be connected in the current networks of dental providers - but they won't just be responsible for dentistry but for all matter of other NHS care from acute care, mental health, optometry, pharmacy the list goes on. So many balls to juggle for ICB leads, so many services, organisations and health needs to get their head around.
It is up to us as dental professionals and the organisations that represent us (such as the BDA, LDNs, LDCs etc.) to actively engage with our local ICBs to ensure that dental care is really put on the map and find innovative and impactful ways to work together within the new system.
If you want to learn more about ICSs, check out this BMA article.
What's your experience engaging with ICSs so far? Please let me know in the comments.
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