In May 2022, the Bristol, North Somerset and South Gloucestershire Integrated Care Partnership (now BNSSG ICB), commissioned the North of England Commissioning Support Unit ( NECS ) to work with their 6 localities, to write their individual strategic plans, within the already-identified key Transformation and System Strategies, Starting, Living, Ageing and Dying Well. The challenge of preparing for the establishment of an Integrated Care Board (ICB), meant that the system needed additional capacity and an independent view, for an integrated health and care system to most effectively deliver to its 4 core purposes, improving outcomes in population health and healthcare, tackling inequalities, enhancing productivity and supporting broader social and economic development.
A series of workshops held with each of the 6 localities, ensured a shared understanding of their identified complex problems, before moving on to address root causes and then move systematically to agree the solutions. The key factor was strong stakeholder engagement with wide representation from local communities, and with locality teams testing outcomes with their communities before moving on to find solutions.
The Cambridge Co-Morbidity score, with locality populations segmented into age groups, with levels of deprivation assessed through the systems linked data set and JSNA data, identified the most impactful conditions.
This was supplemented by the intelligence which professionals’ insight brought and through the lived experience of local people whose representatives played such an active role in the workshops.
The Yale Strategic Problem Solving Methodology identified interventions which most effectively meet the needs of local populations within a manageable number of priorities. Clear sets of priorities and locally determined interventions, provided the basis for the development of a 5-year programme of work for the system and the six localities.
The priorities selected were intended to have a cumulative, system wide effect in targeting improvement up-stream. As examples, where localities identified priorities and interventions ( eg falls and frailty, blood pressure monitoring and Chronic Obstructive Pulmonary Disease), decreases in demand on acute services, particularly unplanned care will follow.
Addressing unhealthy weight in children will have a long-term benefit as people lead healthier lives in adulthood.
The approach taken to deliver the requirements of the BNSSG ICB, align with the principles which underpin the Hewitt Review and offers a framework for how Integrated Care Systems can best be enabled to succeed.
A flexible and innovative approach to strategic problem solving by NECS Consultancy, has provided a method for planning priorities which will deliver real and lasting change to local communities and to the system. The product includes a clear set of priorities for each locality and a means of aligning them with system planning and the transformation agenda. The priorities are developed from a clear evidence base which reflects local population need and opportunities which locally available assets provide.
A strategic planning methodology has been tested across the region and is embedded in the way in which the system will plan its priorities over the next 5 years, with a solid focus on community co-production.
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