System oversight in the new Integrated Care Systems

Ahead of the Health and Care Bill entering Committee stage on Tuesday 7 September we discuss the future role of the Care Quality Commission in regulating ICSs – an issue that has yet to be clarified.

Health leaders have broadly welcomed the Bill and the updates to legislation necessary to support collaboration and partnership working at a local level. It is seen as an important enabler to integration of healthcare services although NHS Trusts and their local partners have been involved in different forms of collaboration for many months, if not years in some regions.

Accountability for quality of care

Currently the health and care regulator can only review health systems with permission from the Secretary of State for Health and Social Care and CQC does not have power to rate ICSs. This has therefore raised concerns around accountability and assurance and how patients will know whether their local NHS, the local Integrated Care System, is doing a good job or not.

We are expecting an amendment to the Health and Care Bill to include provisions to enable the CQC to undertake ratings of ICSs. It is also expected that the CQC’s assessment of ICSs should include consultation with patient groups and consideration of patient outcomes (see Health Service Journal article (paywall), CQC to get new powers through Health and Care Bill amendment).

 But we will have to wait and see what provisions are included in the Government’s amendment and whether the assurance and oversight of systems are aligned with the collaborative and partnership culture underpinning ICSs. It will also be important to ensure that the system works and happens in a light touch way, and does not lead to additional bureaucracy.