What is an NHS integrated care system (ICS)?

An ICS is a subregional level of NHS administration (and finance) in England.

There are 42, which became entities on 1st July 2022. Before the government decided to introduce ICSs, something called a Clinical Commissioning Group (CCG) did a similar role (though there are important differences).

ICSs usually cover 1-2 million people – i.e. roughly ‘county-sized’.

They formed out of a merger of local CCGs – with local acute and mental health hospitals, ‘community trusts’ and general practices (it is hoped) – and most other aspects of the NHS in England.

The administrative level above ICSs are the 7 NSHE Regions, i.e. there will be about 6 ICSs per region. The NHS in Scotland, Wales and Northern Ireland, works independently from England, so will not have ICSs.

What is an integrated care system (ICS), and how are they different from CCGs?

There were 200ish CCGs. They were smaller, covering 150-500k people, i.e. 3-5ish per subregional/county/ICS-sized entity. Also CCGs acted as a ‘commissioner’ or  ‘purchaser’ (i.e. buyer) of healthcare from a ‘provider’ (i.e. seller; hospital, GP, mental and community health for example).

In other words, CCGs were not part of hospitals etc. Whereas for an ICS, the commissioner/purchaser and provider will be the same thing.

So. ICSs are partnerships of organisations that provide healthcare to a larger area and population. Their aim is to coordinate services and to plan in a way that improves population health and reduce inequalities between different groups.

They may have advantages as it will lessen competition between hospitals, encourage co-operation, and reduce the tension between groups within the NHS.

Summary

We have described what is an integrated care system (ICS). Time will tell if they truly integrate and deliver better healthcare.