How can ICS’s support people and communities to have an influential voice?

The NHS recognises that to ensure sustainability, it must improve the integration of its services with other public and voluntary services and accept the vital role of people and communities as part of the solution. On the eve of the launch of integrated care boards, senior consultant Sue Newell asks how we can support people and communities to have a strong and influential voice.  
 
The Health and Care Act 2022 aligns NHS organisations and partners with the strategic intent to improve the health and wellbeing of the population. ​  

As Integrated care boards (ICBs) come into being on 1July, they will oversee this new model of collaborative working of health and care organisations, increasingly partnering with Healthwatch and the wider voluntary, community, faith and social enterprise (VCFSE) sector across systems to better serve all people and communities and address health inequalities.  ​ 

Our existing health and care system has been unable to address perhaps the most difficult challenge of all - achieving equal health outcomes for everyone.  To address this and other associated complex problems, health and care leaders need to understand and know how to meaningfully involve people and communities as a fundamental part of the overall health and care system.  ​ 

For those of us who have worked in this space for many years, we welcome these renewed commitments from current leaders of national NHS organisations to transform the conversation with people, communities, local Healthwatch, and VCFSE organisations.   
 
At Traverse we have been considering how to support system leaders to engage with peers, system partners, people and communities to explore difficult and complex issues in a safe, supported but ultimately impactful way. ​Facilitating collaboration between system leaders, practitioners and people and communities to bridge the gap between strategy, practice and experience to drive forward on better health outcomes for all.  

In the first of our blogs in this ICS series we explored the importance of building trusted relationships and having a clear vision for working with people and communities.  And in the second about the vital role of the VCSE sector to integrated care. There are however other significant factors that systems need to explore to create a fundament cultural shift where people and communities are heard at every level. 

Effective leadership 

One key element is the need for a different kind of effective leadership – more dispersed and empowering – and development support for this - so strategy and decision making is delivered with the involvement of people and communities.  

We have been developing a successful approach that is less about ‘how to do people and community involvement’ (although that is still needed ), but more about how you understand people and community involvement as a core sustainable leadership skill to drive up health outcomes and drive down health inequalities.   

We know that without the latter, actual involvement activities are often less meaningful and effective, which leaves NHS colleagues frustrated and disappointed. 

To tackle inequalities, we must listen to the people behind population data 

The notion of ‘population health’ as a starting point for reducing health inequalities is made possible through more integrated health and care systems. The power of data to drive health improvements is well known, but for real change to take place we need to understand more than the data.  

In our interaction with health services, we see a tendency to focus on quantifiable data, however we really need to recognise the lives of the people behind it.  

Empowering people to support their own health and well-being and tackle health inequalities cannot be transformed as it needs to without those who are experts in their own lives. It may take longer and be messier, but it will lead to better solutions that will be ‘owned’ and utilised by those who need them.  

Evaluate from the start 

While this is the last of our points, we prefer to start thinking about evaluation at the start of any process. Drawing on our work with Integrated care boards we have been thinking hard about how to make sure the impact of people and community involvement is demonstrable and visible at the highest levels.  

Using our expertise in formative evaluation, we have been developing a detailed quality improvement approach to defining and measuring the impact of integrated engagement with people and communities.  

We encourage you to do the same; it will make life so much easier when it comes to reporting back to both the ICB and local residents the impact of working people and communities has had in your area.   

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Traverse is helping ICSs develop programmes and strategies to achieve good health outcomes for all through the power of people to inform and influence change: we do this through strategic leadership support, evaluation and research, engagement and consultation. 

If you would like to have a conversation with us about our work, please get in touch with Sue.Newell@traverse.ltd