The Hewitt Review: plans for integrated care

The Hewitt Review reported earlier in April on the oversight, accountability and governance of the Integrated Care Systems (ICSs) that are recently formed and making their way into changing the way health and care are delivered. The legal frameworks came into being in July, last year, as the Health and Care Act 2022, so the review was commissioned to add some needed detail and to help along the new relationships that are being made as the systems bed-in. Patricia Hewitt is a previous Health Minister in the New Labour government and is currently chair of the Norfolk and Waveney ICS. As part of the Review, she consulted widely, including all the 42 ICS organisations, as well as a comprehensive range of leaders from across the NHS in both acute, primary and mental health, local government and many other stakeholders with an interest. 

The timing of the new organisations and development of key relationships may be said to be in the eye of the storm, while there is such turbulence around health and social care. The backlog of care is keeping clinicians very busy, and there are unprecedented shortages of staff across primary, secondary and social care organisations. This does not help the development of new organisations and their delivery mechanisms, not to mention the spectre of continuing strikes which affect everyone, including patients and staff. 

The focus of the ICSs is to deliver on their four main statutory purposes: improving health outcomes and services, reducing health inequalities, delivering a financially sustainable health and care system and supporting our communities’ social and economic development.¹ The Hewitt Report seeks to identify how the integration and collaboration changes can work to deliver them and all in a suitable governance framework, while enabling leaders the freedom to innovate.