The delay in formally launching the ICSs creates problems in empowering ICB and ICS leaders to manage a place’s health needs, with CCGs unable to be phased out, as well as an anticipated issue of creating two year-end periods, just three months apart.
However, the additional time does allow for further collaborative conversations to take place, ensuring that all parties within the system, both hospital- and community-based, are fully aware of processes and requirements.
All NHS leaders will be all too familiar with the difficulties of embedding new technology and processes within trusts. It can be expected that processes and platforms will be required to change in at least some partner organisations within a system, and so the delay may be used to ensure that essential programmes, education and support can be put into place to allow for smoother transition to collaborative working. In those systems where more than one CCG is required to come together, the delay allows a potentially messier move more time to be supported and transitioned.
The delay also allows ICS leaders to continue to focus on the system architecture, and with many still planning to be up and running by 1st April regardless of the delay, the date shift creates a period of shadow operation to enable testing. With that, the system will be in place and running by 1st July, with the staff, contract and ledger transfers taking place on that date.
A delay is never ideal, and not what ICS leaders will want when facing the transition from CCGs to broader system working, and the challenges that the process creates. However, where benefits – or silver linings – can be found, we would hope to see the transition become advantageous for everyone involved, from management to patient.