Our approach to assessing integrated care systems

Published: 20 March 2023 Page last updated: 9 June 2023

We recently published information on our approach to assessing local authorities and interim guidance on how we will carry out our assessments. This explains how we are working with partners and outlines the timelines for starting our assessments of how well local authorities are meeting their duties under the Care Act 2014.

Our role

The Health and Care Act 2022 also gives us powers to assess whether integrated care systems are meeting the needs of their local populations. We expect these new powers to start this April. They will enable us to understand how integrated care systems are working to tackle health inequalities and improve outcomes for people. This work will also provide independent and meaningful assurance to the public of the quality of care in their area.

Our interim guidance for assessing integrated care systems, which is awaiting government approval, is now available.

To design these assessments, we have been working in partnership with:

  • people who use health and social care services and their families
  • health and care providers
  • integrated care systems
  • local government organisations
  • Department of Health and Social Care (DHSC)
  • NHS England
  • other bodies representing providers and strategic partners.

We will continue working in this way with our partners.

Our 'test and learn activity’ on aspects of our overall assessment approach has provided feedback and learning, which we have used to refine and adapt the methods we will use. We are also engaging with the Hewitt Review process. When the findings of the review are published, we will consider any important implications for our approach that may result in amendments to our interim guidance.

Our approach

Integrated care system assessments

The Health and Care Act 2022 states that our approach to assessing local authorities and integrated care systems is subject to the approval of the Secretary of State for Health and Social Care. We are currently awaiting this approval.

April to July 2023

We propose a similar approach to assessing integrated care systems as that outlined for local authority assessment.

For integrated care systems, we will start to form a national view of performance, initially focused on themes in this quality statement:

  • Equity in access

This would show whether systems are working together to support people to access the care, support and treatment they need when they need it. It includes how they are responding to inequalities of access across their populations. Our findings will inform our annual 'State of Care' publication.

Going forward from this point, we plan to pilot our approach with some integrated care systems before starting formal assessments. We will carry out further assessments of integrated care systems, taking into account the learning from our pilot approach and our national view of equity in access.

We’re working closely with the Department of Health and Social Care on how we will deliver further assessments beyond this point.

You can now read our current interim guidance for assessing integrated care systems.

Interim guidance on our approach to assessing integrated care systems

This sets out the overall framework for our oversight of integrated care systems, focusing on the initial baselining period. It includes how we plan to gather evidence, report on findings and award ratings if requested to by HM Government.

The guidance focuses on:

  • Themes and quality statements
  • Evidence categories
  • How we will assess integrated care systems
  • Reporting and sharing information
  • Intervention and escalation

As we develop our model and transition to ongoing assessment, this guidance will include more detail. It will form the basis for comprehensive guidance on our regulatory processes.

Local authority assessments

Find out more about our interim guidance and update on our approach to assessing local authorities.

The assessment framework that we will use for local authority assessment is now also available

We have engaged extensively to develop this assessment framework to enable us to use our new powers. This interim framework will help local authorities to prepare in the lead-up to April 2023, when we expect to start our assessments.

As integrated care systems are new entities, our approach to assessing them and our timeline differs from that of our local authority assessments. In our assessments of integrated care systems, we will work closely with NHS England. NHS England provides leadership, oversight and support for NHS services in England, and carries out an annual performance assessment of integrated care boards which are due to publish later this year. If you work within an integrated care system or a local authority you can register your interest to get further updates from us about this work. We will then add you to the mailing list.