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Berkshire West Integrated Care System (ICS)

An Integrated Care System (ICS) is one in which local NHS organisations (both commissioners and providers), often in partnership with local authorities, choose to take on clear collective responsibility for resources and population health, providing joined up, better coordinated care.

The Berkshire West Integrated Care System includes Berkshire West Clinical Commissioning Group (CCG), the acute Royal Berkshire Hospital and Berkshire Healthcare Foundation Trusts, and providers of GP services in four locality or neighbourhood ‘alliances’. The system covers a registered population of approximately 528,000 residents in Reading, West Berkshire and Wokingham.
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Through what is known as the Berkshire West 10 Integration Programme, the system works closely with South Central Ambulance Service Foundation Trust and the three local authorities in the area: West Berkshire Council, Wokingham Borough Council and Reading Borough Council. The local government chairman of this parallel programme has a seat on the integrated care system leadership group to ensure the two programmes are mutually supportive.

The integrated care system is based on voluntary collaboration founded on the principle of reaching joint consensus. The CCG governing body and the foundation trust boards remain the statutory decision-making bodies. An integrated care system unified executive group, including all partner organisations, has responsibility for delivering the programme of work and for monitoring and reviewing the financial performance of the integrated care system and its constituent organisations.

Berkshire West was recognised by NHS England (NHSE) as an ICS Exemplar area in June 2017 and is one of 10 Integrated Care Systems across England.

The vision

The main objective of the ICS is to ensure that our population’s experience of healthcare services will continue to improve; that our population continues to benefit from improved health and wellbeing outcomes and that the local NHS is financially sustainable for the future. Specifically this means:

  • Making faster progress in transforming the way care is delivered, as set out in the NHS Five Year Forward View, and in particular making tangible progress in urgent and emergency care reform, strengthening general practice and improving mental health and cancer services.
  • Managing these and other improvements within a shared financial control total and to deliver the system-wide efficiencies necessary to manage the local NHS budget.
  • Integrating services and funding, operating as an integrated health system, to manage the health of the local population, keeping people healthier for longer and reducing avoidable demand for healthcare services.
  • Demonstrating what can be achieved with strong local leadership and increased freedoms and flexibilities, and share learning with the wider NHS.
How will the ICS benefit patients?

More people now need care across a number of different settings; hospitals, primary care, clinics, nursing homes and home care agencies – which are often not well co-ordinated. The result of this for our patients is a system which produces variable quality of care and where patients may experience lapses in care as they move between organisations. Our aim is that the ICS facilitates more collaborative working between the organisations in Berkshire West, which will ensure our services meet the health and care needs of the local population.

In the video below, Wokingham patient, Guy, tells how care delivered by an integrated, multi-disciplinary team has improved the quality of his life.

We expect that benefits will be realised from all aspects of this transformation, in our hospitals and in our ‘community’ settings of care which includes primary care services. We will know that we have achieved these benefits if:

    • People will be supported to take care of their own health and well-being
    • Care is being provided closer to home, wherever appropriate
    • Clinical pathways are better integrated across providers to improve patient experience
    • The capability and capacity of primary, community and social care is increased to provide multidisciplinary “wrap around” co-ordinated care that efficiently meets the patient’s needs
    • We have a better understanding the clinical needs of our population and maximise the opportunity to prevent, and to intervene early to reduce the need for more intensive on-going care
    • We have a high quality, fit for purpose acute and specialist hospital service
    • We have a shared Quality Strategy with system wide approach to the delivery and monitoring of quality
    • We operate to single budget for the whole health care system, making the most effective use of the Berkshire West pound and delivering financial sustainability
    • Staff and workplace wellbeing is improved, and we build a sustainable and highly skilled health and care workforce in Berkshire West.

The benefits are explained in the animation below:

How are decisions made?

The ICS is based on voluntary collaboration of local NHS bodies founded on the principle of reaching joint consensus. The CCG Governing Body and the Foundation Boards remain the statutory decision making bodies in our system.

To support our joint working, we have established an ICS Unified Executive group, which includes senior executives and clinicians from all partner organisations, who take responsibility for delivery of the ICS programme of work and monitoring and reviewing the financial performance of the Integrated Care System and its constituent organisations.

Where changes to clinical pathways and services are identified we will work with local residents to shape and develop improvements in response to local needs.