51 Suffolk and North East Essex ICS | ‘Our Journey Together’ Two new types of contract - covering single or multiple neighbourhoods—are expected to support the delivery of neighbourhood care. However, there is currently no consistent definition of a “neighbourhood,” and different public sector bodies use the term in different ways. Early agreement on neighbourhood boundaries and functions will be essential, especially as these arrangements become more visible to the public. A new model, the Integrated Health Organisation (IHO), is also expected to emerge. IHOs will likely involve a single provider responsible for much of the prevention, diagnosis, treatment and care within a place. These models are expected to begin emerging in 2026/2027. This reinforces the shift towards NHS ICBs acting as strategic commissioners rather than direct delivery bodies. It also highlights the need for strong early collaboration between health providers and the new Unitary Authorities, which will be central partners in public health and social care. 6.2 New opportunities The ecosystem of the public sector is changing at an unprecedented pace. With new organisations and existing ones taking on different roles in strategy and delivery, understanding new roles and responsibilities of partners will be of vital importance. Organisations in the public sector have always been focused on population health improvement and reducing health inequalities but the siloed working and misaligned geographies that we have seen has often caused challenge to really being able to impact on these issues. These changes to responsibilities along with geography will allow us to address these issues but delivery may be more challenging during the next two years with so many changes happening all at once. With that being considered, the well-established partnerships and underlying relationships should be seen as a positive state to be in to address health and health inequalities. The lessons from the past 10 years as a leading integrated care system should provide valuable lessons for this reflect, reset and renew period we are entering. With Suffolk and North East Essex ICS being recognised nationally for the collaboration and integration it has demonstrated which are some of the key components needed to deliver system change especially given the parameters it worked within. However, even with all of the positive work Suffolk and North East Essex has done, we still see significant issues with the health of our populations, a widening of health inequalities and organisations often at crisis point. Understanding the lessons from Suffolk and North East Essex ICS should be considered as we move forward and this report aims to enable that. The question is then how do we develop into a new ecosystem that is based in prevention, early help and equity? If these are the shared priorities, we may be able to deliver the national ambitions which are held locally by partners as well. If we were able to find a new way of being as an ecosystem, taking collective action on the entire health, wellbeing and care pathway, maximising the contribution of every part of the system, we could well achieve our aims. This should not be seen as wishful thinking. Many partners now see it as the only option we have to ensure sustainability, value and to address the issues for our populations and across the public sector. So how do we embrace these changes over the next few years? There are risks. The ICB’s being established prior to the new local government structures will require flexibility and agility of the NHS to adapt as these emerge. Specific consideration must be given to ensuring that places and neighbourhoods in health align to those in local government as previous issues associated with misalignment cannot be repeated. Mis-matched priorities may also be an issue. With the NHS increasingly concentrating on healthcare delivery, remaining focused on all of the pillars of being an ICS may be challenging. However, if the NHS is focused on the three strategic shifts, and there is no option but to remain focused on these then that will require an investment in relationships with partners who influence many of the prevention and upstream factors that ultimately lead to poor health. With many ICB’s possibly seeing this as optional rather than essential, there are risks that opportunities for prevention and early intervention may be missed.
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