1. North East and North Cumbria Integrated Care System
Alan Foster
ICS Executive Lead

2. Progress update and next steps
ICS status for North East & North Cumbria now formally approved by NHSE/I; a real vote of confidence in our system approach
Our ICS is a collaboration of NHS commissioners and providers (and our partners), and not a new organisation with statutory powers
MOU will follow from Richard Barker setting out our responsibilities as a system and how NHSE/I will work with us
Subsidiarity remains our guiding principle, with the majority of our work focused in places and neighbourhoods
But, alongside this, our ICS provides a mechanism to build consensus on those issues that need to be tackled at scale.
We’ve listened to our member bodies and have already reduced ICS workstreams from 22 to 6
Our voice is already being heard nationally: with ARC funding and Interim Workforce Plan pilot status secured, and an invitation to bid for Population Health Mgt funding
 Next steps
Formal endorsement of the high-level ICS MOU at governing bodies & boards in Sept
In depth work with you all to agree a governance and clinical leadership model for our ICS
Engage with Local Authorities on the opportunities of joint working, and agree ICS Partnership Assembly arrangements (Neil Mundy leading)

3. “doing the right things at the right level with the right partners”
Key challenge:
“doing the right things at the right level with the right partners”
National
Neighbourhoods/Primary Care Networks
(30-50,000 population sizes)
Place-based
(Local Authority/CCG size)
ICPs
(Sub-regional/Combined Authority level)
ICS
(North East & North Cumbria)
Regional & National
People

4. NHS North & Yorkshire in 2018
One NHSE/I region, with
Four Integrated Care Systems
NHS in 1948

5. One North East and North Cumbria ICS
with four Integrated Care Partnerships (ICPs)
North East Ambulance Service FT covers North, Central &South ICPs
NTW Mental Health FT covers the North and part of Central ICP
TEWV Mental Health FT covers the South and part of Central ICP
‘North’
Population 1.025M
3 CCGs: Northumberland, North Tyneside, Newcastle Gateshead
24 Primary Care Networks
3 FTs: Northumbria, Newcastle, Gateshead
4 Council areas: Northumberland, North Tyneside, Newcastle, Gateshead
‘North Cumbria’
Shadow ICP 1 April 2018
Population 327,000
North Cumbria CCG
8 Primary Care Networks
North Cumbria University Hospitals
Cumbria Partnership FT
Cumbria County Council
North West Ambulance Service
‘Central’
Population 992,000
4 CCGs: South Tyneside, Sunderland, North Durham, DDES
24 Primary Care Networks
3 FTs: South Tyneside & Sunderland CDDFT
3 Council areas: South Tyneside, Sunderland, County Durham
Overall population 3,191,000
North
‘South’
Population 847,000
4 CCGs: HAST, Darlington, S Tees, HRW
17 Primary Care Networks
3 FTs: CDDFT, North Tees, South Tees
6 Council areas: Hartlepool, Stockton on Tees, Darlington, Middlesbrough, Redcar & Cleveland, North Yorkshire

6. 1 North East & North Cumbria ICS 4 Integrated Care Partnerships (ICPs)
Local Authority Engagement opportunities – via Health and Wellbeing Boards and Combined Authorities
1 North East & North Cumbria ICS
4 Integrated Care Partnerships (ICPs)
North of Tyne Combined Authority
Newcastle upon Tyne
North Tyneside
Northumberland
North East Combined Authority
County Durham
Gateshead
Sunderland
South Tyneside
Tees Valley Combined Authority
Darlington
Hartlepool
Middlesbrough
Redcar and Cleveland
Stockton-on-Tees
3 Combined Authorities
2 Counties with districts (Cumbria and N Yorks)

7. ICS Places and neighbourhoods Integrated Care Partnerships ICP ICP ICP
Areas of focus
Partnership working between NHS and local authorities via Health & Wellbeing Boards
Ensuring the quality, safety and accountability of local health services
Public and political engagement and consultation
Primary Care Network development
Health and Social Care Integration initiatives
Joint-working with the local voluntary sector
Places and neighbourhoods
North
Focus on acute services sustainability: clinical networking between neighbouring FTs and coordination of service development proposals
One streamlined commissioning hub per ICP
Work towards a single, shared approach to finances, and risk-sharing where appropriate.
Make best use of the existing premises and facilities and jointly plan capital investments
Integrated Care Partnerships
ICP
ICP
ICP
ICP
Strategic Commissioning (e.g. ambulance)
Overarching clinical strategy and clinical networks
Shared policy development
Emerging ICS-level priorities:
Population Health & Prevention
Optimising Health Services
Workforce Transformation
Digital Care
Mental Health
Learning Disabilities
Integrated Care System
ICS

8. Emerging ICS Workstreams
ICS Health and Care Strategy (response to LTP)
1. Optimising Health Services (including all our clinical networks)
4. Population Health & Prevention
2. Workforce Transformation
5. Mental Health
3. Digital Care
6. Learning Disabilities
Financial strategy
Operational delivery

9. DRAFT Governance flowchart for issues escalated to ICS-level only
CCG Joint Committee
Local Authorities
CCG Governing Bodies
FT Boards and Committees in Common
Stage 4
Formal approval at one or more of these decision-making bodies (as required)
Health Strategy Group
(Wider Clinical & Managerial Leadership)
Stage 3
Discussion at CCG governing bodies, FT boards and Health and Wellbeing Boards as appropriate
Sign-off from ICS senior leaders at HSG
ICS Management Group
(CEO reps from each ICP)
Stage 2
Assessment and quality assurance of :
ICS work programme proposals, or
Risks and issues raised by ICPs
ICS Clinical Leadership Group
ICS Financial Leadership Group
Stage 1
Recommendations from ICS work-programme boards (eg Prevention Board, Workforce Board) , quality monitoring groups and clinical networks, or
Escalation of risks and issues from ICPs
PROPOSALS, RISKS AND ISSUES
ICS Partnership Assembly?
Shaping and influencing our strategic priorities

10. ICS Partnership Assembly (TBC)
Shaping and influencing our strategic priorities
Statutory decision making
CCG Joint Committee
CCG Governing Bodies
FT Boards
Health Strategy Group
(Wider Clinical & Managerial Leadership)
ICS Clinical Leadership Group
Local Authorities
ICS Management Group
(CEO reps from each ICP)
ICS Financial Leadership Group
North ICP
South ICP
Central ICP
North Cumbria ICP
13 Health and Wellbeing Boards
Optimising Health Services
Workforce
Transformation
Population Health & Prevention
Digital
Care
Mental
Health
Learning Disabilities
Integrated Care Partnerships
ICS Priority Workstream boards

11. Thank you