On Friday, NHS England published the first set of guidance on the changes being made in the Health and Care Bill, expected to return to Parliament imminently. The guidance document ‘Building strong integrated care systems everywhere: ICS implementation guidance on working with people and communities’ expands upon the Bill and the ICS design framework to explore how the new ICSs will be expected to engage with and involve their communities in the actions of both constituent parts of the ICS- the integrated care boards, and the integrated care partnerships.

As part of the constitution of the ICB, mechanisms for public involvement are expected to be laid out, and this is our first glimpse at what NHS England will be expecting to see, and how they expect those duties to be applied. The guidance outlines ten key principles they expect to see:

1. Put the voices of people and communities at the centre of decision-making and governance, at every level of the ICS.
2. Start engagement early when developing plans and feed back to people and communities how their engagement has influenced activities and decisions.
3. Understand your community’s needs, experience and aspirations for health and care, using engagement to find out if change is having the desired effect.
4. Build relationships with excluded groups, especially those affected by inequalities.
5. Work with Healthwatch and the voluntary, community and social enterprise (VCSE) sector as key partners.
6. Provide clear and accessible public information about vision, plans and progress, to build understanding and trust.
7. Use community development approaches that empower people and communities, making connections to social action.
8. Use co-production, insight and engagement to achieve accountable health and care services.
9. Co-produce and redesign services and tackle system priorities in partnership with people and communities.
10. Learn from what works and build on the assets of all ICS partners – networks, relationships, activity in local places.

These principles highlight the significance that the new structure is placing on public engagement and provide a solid framework around which engagement plans and mechanisms can be built to support the work of ICSs going forward.

Perhaps of particular note is principle number 4- the Institute has long believed that health inequality is one of the next big challenges for the NHS, reinforced by its appearance in the Keppel court case last year. The pandemic too has highlighted significant disparities in healthcare, and it is heartening to see this issue listed as one of the key priorities for NHS England.

Today sees the publication of Briefing Paper 40: Emerging issues from the Health and Care Bill 2021, the Institute’s most comprehensive examination of the new legislation- the Briefing Paper can be found in the Members’ area of the website. For further information, please contact the Institute.