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We will explore how the local partners involved in ICSs are working together to tackle problems that are system wide, and hence require a system-wide solution.

Why we are doing this project

There are 42 integrated care systems (ICSs) in England. These are partnerships that bring together NHS organisations, local authorities and others to take collective responsibility for planning services, improving health and reducing inequalities across geographical areas.

ICSs took on new statutory powers and responsibilities for the first time in July 2022. These changes have the potential to accelerate the adoption of integrated care across the country and bring about the improvements that are urgently needed in health and care. However, these changes have been introduced in an extremely challenging context. Financial pressures, a cost-of-living crisis, growing waiting lists for care, industrial action, and a health and care workforce shortage all threaten to undermine ICSs’ ambitions for improved population health.

The King’s Fund is undertaking a major piece of research to explore how ICSs are developing in this early phase. We want to find out how the local partners involved in ICSs are working together to tackle problems that are system wide, and hence require a system-wide solution. We are using workforce as a lens through which to explore how ICSs are progressing.

All 42 ICSs have developed plans around workforce. Each one is working out how they can best recruit, retain and redesign a workforce that will meet the needs of their local population. This research focuses on how ICSs are tackling the workforce issue and how local partners are collaborating to deliver solutions, now and for the future. The research will also provide broader insights into how ICSs are developing since taking on their statutory form and how well they are achieving their ambitions. The project will offer recommendations as to how best ICSs can be supported to work as a system and fulfil their aims.

What we are doing

We will be assessing what progress ICSs are making on creating a workforce that meets the needs of their local population, now and in the future.

We are exploring how partners across an ICS are working together, and will examine themes including:

  • How are local partners working together to recruit, retain and redesign their workforce?

  • What roles are ICSs playing in fostering system-wide working?

  • How are local systems balancing short-term priorities with longer-term workforce transformation?

  • What are the key risks and opportunities ahead?

The research will consist of three phases:

  • A scoping phase to identify the key issues around workforce for people working in ICSs. This includes scoping interviews with stakeholders across a number of ICSs.

  • Qualitative research to dive deeper into the perceptions and experiences across four ICSs. We will interview a range of stakeholders from across the system who are involved in workforce/people strategies, including from the voluntary and community sector.

  • Sense-checking our findings with a wider group of stakeholders. ICSs are implementing their strategies in different ways and we want to understand whether our findings from the four case-study sites are relevant to others.

Key milestones

The research started in July 2023 and the final report is expected to be published in spring 2024. We plan to publish blogs and share emerging findings as the project unfolds.

The project team