Time to be bold - shaping the future of our health and care system

It’s time to be bold about the future of health and care. Read our blog by Frances O'Callaghan , CEO of North Central London ICB, to find out what we submitted to the Change NHS consultation and how you can get involved in shaping the future of the NHS.

A couple of months ago, the Government announced that it was undertaking a ‘national conversation’ to shape the future of the NHS – Change NHS. 

I’ve really welcomed the opportunity Change NHS has brought to have fresh conversations about the future of the NHS over the past few weeks. 

On Sunday 8 December it was Londoners’ turn to give their views on the future of the NHS and the 10-Year Plan for health and care. In this blog I’m going to give you an overview of what we, as North Central London Integrated Care Board, have submitted as our organisational response to Change NHS. I’m also going to talk about how we’re evolving our thinking on the future of the NHS 

There are several ways to feed in views to the Change NHS consultation if you haven’t already. Organisations could submit a response by 2 December and all individuals can respond here: https://change.nhs.uk by early 2025.   

What does the 10-year plan needs to focus on? 

I’ve had some fantastic conversations over the past few weeks about the future of health and care. There is a real sense that across North Central London we want to see more of a focus on mental health, children and young people, we want to demystify what we mean by technology in care, and we want to support NHS staff to do their jobs. We cannot do any of this without being bold.     

Children and young people 

Children and young people are the future. We all know it – and yet we have not gone far enough to transform our system around them. Over 3,000 children and young people were waiting to be seen by Community CAMHS in March 2024, a third of children and young people waiting for treatment.  

 A truly preventative approach to health and care has them at the heart, receiving timely interventions from the right services. Proactive care is essential for addressing the rising demand for Special Educational Needs (SEN), mental health services, needs assessments and more.

We need to do so much more to get in early to support the needs of children with a learning disability and autistic people. For those who need a lot of support, we’re too reliant on the private sector for placements, and because of that, we often fall short of providing tailored care packages that are truly person-centred and community based.  

Mental health 

Prevention is better than cure for almost all conditions, and in particular mental health. We know that 14,000 adults suffer from severe mental illness across North Central London and that waiting times are too long. We need high quality talking therapies, community models of care for those who need additional support, and a range of other therapies to support a holistic approach.  

Neighbourhoods  

The 10-Year Plan also needs to support ICBs in our role to bring services together locally around the needs of people. We see neighbourhood working as a fantastic vehicle deliver on our ‘Population Health Strategy’ in a much more localised way – ensuring the person’s journey is at the heart, rather than the person jumping around from service to service.  

Accountability for improving outcomes must sit with all partners of the system – it is a partnership endeavour. If accountability is not shared, we’ll never truly achieve the shift left away from a solely medical model. All partners in a neighbourhood approach including health, the voluntary sector, social care, mental health and more need to be incentivised to work together to analyse variation in access and outcomes and take action to reduce this.  

Infrastructure, buildings and investment 

We can’t expect partners to work together in a more joined-up way without the technology, investment and infrastructure to support it. To create a truly team-centred approach, teams need to have access to shared IT systems that work, estates that support collaborative working, and financial investments to deliver these. 

We must move towards a more long-term approach to planning and delivering services. A five-year capital planning cycles would allow for more predictable and targeted investments in facilities, technology, and community-based services. 

Life sciences 

NCL’s providers are at the forefront of delivering world-class services and research, from work on genome testing to regenerative hearing loss research and identifying the link between a COVID-19 vaccine and rare cases of blood clots. 

Academic, clinical partnerships across life sciences are significant for NCL. We need greater permissions and flexibility regarding land use and work with SMEs and universities to enable roll out of inventions that benefit health. The National Health Research Institute is funding a NCL Research Engagement Network, and Islington-focussed Health Determinants Research Collaboration. These create opportunities to develop our evidence base for planning, commissioning and measuring progress against our Population Health Strategy. 

Local and national public health campaigns must be informed by experiences and insights from ICBs and primary care and use a disease prevention and behavioural sciences approach. 

Next steps 

Many of the changes we need are not new, but as an ICB, we are using this as an opportunity to truly push for the changes we need at a national level.  

I’m glad to say that what we’ve heard from people so far really chimes with our population health outcomes, and we’ll be using this insight in the delivery of our Population Health strategy. 

So what now? We will hear from the government in Spring 2025 about the next steps with the 10-year plan. I’m really looking forward to seeing how our collective insights shape the future of the NHS.