An MPs committee report has expressed concern that the success of Integrated Care Systems (ICSs) could be jeopardised by a ‘command and control’ approach.

The Health and Social Care Committee report said it was vital that the government and NHS England did not dictate how ICSs deliver local outcomes.

Chair of the Health and Social Care Committee, Steve Brine MP, said: “This is a key moment for ministers and for NHS England. We have found genuine enthusiasm for the potential of Integrated Care Systems to make a real change, not only in how health and social care is delivered but in prioritising the needs of local populations and preventing ill-health.  

“It would be an opportunity lost if that success was undermined by the need to prioritise central government targets or a focus on meeting short-term demands. We urge ministers not to lose sight of the crucially important prevention agenda and we call for them to adopt a light-touch outcome driven approach to this new way of working.”

Sarah McClinton, president of the Association of Directors of Adult Social Services, welcomed the report’s findings, commenting: “MPs are right to challenge the NHS and the government to focus targets on outcomes and not try to dictate from the top-down what activities should be prioritised. Integrated Care Systems should be about genuinely sharing power, shifting decision making closer to people and ensuring they are not just about NHS services, but have social care, public health services and the voluntary sector at the heart of decision-making and delivery.

“Critically, the government needs to ensure that Integrated Care Systems are not just left to deal with the immediate crisis in health and social care. If they are genuinely going to build a health system that acts for the long-term, investing in way to prevent ill-health and improve well-being in their communities, they will need the resources to do that. And they will need the government to intervene to solve the current crisis. That includes a long-term, fully funded plan to reform adult social care, so we can address the staffing crisis and have sustainable funding that will meet the needs of all older and disabled people and their carers in future.”

Miriam Deakin, director of policy at NHS Providers, said: “We welcome this report and many of the inquiry’s key recommendations having contributed written and oral evidence. Trust leaders will agree that central targets for ICSs should be outcomes-based, and that the government and NHS England should be less prescriptive about how targets are met.

“This, and allowing systems greater flexibility to agree local priorities for improving the health of their populations, will enable them to better meet the needs of their communities – including addressing health inequalities. Trusts are key to delivering on this and are fully committed to it.

“As this report suggests, over time, we would welcome more clarity on how ICSs will deliver against their four core aims, as well as how partnership working. This is a top priority for trusts and should be assessed and supported. ICSs and ICBs vary in maturity, population size, levels of deprivation and the make-up of providers locally, so their support needs will vary.

“Trust leaders are clear that provider collaboratives can and must play a key role in delivering and transforming services, improving value and driving up quality of care within the system context. We look forward to the Hewitt Review, which should set out how ICSs, including trusts, can implement many of the themes in this report.”

A Department of Health and Social Care spokesperson said: “Integrated Care Systems (ICSs) are a crucial part of the government’s vision to bring together the NHS and local government to improve health outcomes for people in their communities and tackle inequalities in access to care.

“To ensure we have the right arrangements to support ICSs, in November 2022 we announced an independent review focusing on autonomy, accountability, the use of data and the role of the Care Quality Commission.  

“We have received the Health and Social Care Select Committee report and are looking ahead to the findings of the independent review. We will consider both and respond in due course.”