9 Suffolk and North East Essex ICS | ‘Our Journey Together’ 2. Our Evolution How we developed as an ICS 2.1 History of health and social care integration in England Integration between health and social care has been an explicit ambition in English health policy for over 50 years, with roots traceable to the early 1970s or before, and recurring prominently in every major reform cycle since. However structural, financial, and organisational barriers have made sustained integration difficult to achieve. In the 1970s the NHS Reorganisation Act 1973iv attempted to align health services with local authority social care, marking one of the first formal pushes toward integration. Although the structures didn’t fully deliver integration, the ambition was clearly articulated at this stage. Later in the 1990s–2000s there was renewed focus with the NHS and Community Care Act 1990v shifting some responsibilities to local authorities and an emphasis on joint planning. Throughout the 2000s, policies also encouraged partnership working, pooled budgets, and joint commissioning. Integration then became a core national priority with the 2014 NHS Five Year Forward Viewvi, which called for “triple integration” across: primary and secondary care, physical and mental health, and health and social care. National Vanguard sites and the concept of Sustainability and Transformation Partnerships (STPs) were launched with the aim of testing integrated models. This was the beginning of a lengthy process that led to the establishment of statutory Integrated Care Systems in 2022. 2.2 Suffolk and North East Essex STP – 2016-2017 In 2015 NHS England’s ‘Delivery of the Five Year Forward View’vii required the NHS to produce a five year Sustainability and Transformation Partnership (STP) Plans and One Year Operational Plans for 2016/17. In the following year, 2016 NHS England announced the footprints for 44 STPs across England, creating Suffolk and North East Essex as a health and care system for the very first time. STPs were initially introduced as nonstatutory partnerships, created to promote integrated planning across NHS trusts, Clinical Commissioning Groups (CCGs) and local authorities. Nick Hulme, Chief Executive of Colchester Hospital University NHS Foundation Trust and Ipswich Hospital NHS Trust, initially served as Suffolk and North East Essex STP Executive Lead. The STP covered a population of 953,000 people and initially involved Suffolk County Council, Essex County Council, local district and borough councils, three NHS Clinical Commissioning Groups, NHS provider trusts and over 100 GP practices and hundreds of primary care providers. Later in 2016, further key appointments were made including Susannah Howard as STP Programme Director, and Alan Burns as STP Chair. The STP Board was established, and published its first STP Plan, which focused on self-care and independence, communitybased care, hospital reconfiguration and transformation, and collaborative working across the health and care system. In 2017, the NHS proposed Integrated Care Systems as a new model for local health and care. Suffolk and North East Essex STP published its Delivery Plan and agreed to develop three place-based Alliances: Ipswich and East Suffolk, North East Essex and West Suffolk. Agreeing the formation of the Alliances was key to securing support for the ICS as for several partners the Suffolk and North East system footprint presented difficulties, and place-based working provided more local opportunities for partnership working and integration. However although the Alliance footprints matched those for the three local NHS Clinical Commissioning Groups at the time, they were still not coterminous with Mid Suffolk and Babergh district councils. Picture – map showing the geographical areas for the three place-based Alliances agreed in Suffolk and North East Essex
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