Supporting integrated care systems to work in partnership with people and communities

Earlier this year, we were delighted to announce a new project with CQC and the Point of Care Foundation, funded by the Regulators’ Pioneer Fund. Together, we have been developing a rigorous, scalable, self-assessment framework for integrated care systems (ICSs). This framework is designed to improve ICS engagement with people and communities, with the aim of reducing health inequalities. Our key consideration at National Voices is to ensure this framework is co-produced with voluntary, community and social enterprise (VCSE) organisations and people with lived experience of health conditions and disability. 

I welcomed the opportunity to join the Expert Advisory Group (EAG) for this project at the start of this year. We’re now halfway through the process, and about to embark on testing the draft framework with the ICS pilot sites. 

My role in the Expert Advisory Group

I co-chair the EAG alongside Jacob Lant, Chief Executive of National Voices, the leading coalition of health and care charities in England. The draft framework has been co-designed with a range of people and organisations, to ensure that the end result makes sense to everyone and is useable at every level of an ICS. Read more about co-design.  

The EAG first came together very early on in the project and our first few conversations were very conceptual in nature. Those early conversations, both within the EAG and with wider stakeholders, were crucial to the development of the framework. The Point of Care Foundation then did an excellent job of bringing together all our theoretical discussions to design the framework. 

It’s been great to work with a wide range of people across this project. The EAG brings together people with lived experience of health inequalities, people from VCSE organisations and people from statutory organisations. I’ve also been involved in discussions with wider stakeholders across the health and care system, ensuring that a diverse range of viewpoints and experiences feed into the development of the framework. 

Why this framework is important

Integrated care boards (ICBs) have a legal duty to make arrangements to involve the public in their decision making about NHS services. The Working in partnership with people and communities: Statutory guidance sets out the ambitions for this, including: “a health and care system that:… prioritises hearing from people who have been marginalised and those who experience the worst health inequalities… and… shares power with communities so they have a greater say in how health services are shaped.” 

The framework we have developed is intended to complement existing guidance and strategies. It provides a way of measuring how an ICS is performing in its engagement activities, and details clear targets for improving how it engages with people and communities.   

It’s so important that this framework provides a practical improvement tool, and that it drives action and change. Some ICSs already have established meaningful relationships with the people and communities in their area, others are just beginning to forge these connections. These relationships are vital to making health systems work better for local communities. The framework is designed to guide ICSs regardless of how far along they are in this important journey. 

Good, meaningful engagement enables people and communities to influence decision making and guide improvements. When they are valued and enabled to influence decision making, people with lived experience can provide innovative ideas and a range of skills and expertise. So often, people are seen as solely ‘patients’ or ‘service users’, which diminishes their ability and desire to engage. People are experts, not only often in their own health, but in their lives, in their neighbourhoods and their communities. Who better to work with in reducing health inequalities, than people who live those inequalities every day? 

My hopes for this framework

I want people to pick up this framework and feel encouraged to build on both how they engage with people, and the impact that that engagement is able to achieve. Our key aim is that the framework is accessible and useful, not only to the people and organisations working as part of an ICS, but to the people and communities involved in engagement activities.  

My hope is that the framework will be easy to use and effective, and that it will succeed in its overall goal of supporting ICSs to work in true partnership with people and communities who experience health inequalities. By working closely together, local people will be empowered to work with ICSs to reduce the health inequalities that affect their own lives, and the lives of people in their communities. By using the framework and working in this way, we hope to help ICSs realise their true potential. 

Biography

Robyn is Lived Experience Advisor at National Voices. 

Robyn sustained a spinal cord injury in 2006 and has needed 24-hour care ever since. Initially provided through traditional care agency services, Robyn moved to a personal health budget in 2015 which enabled her to employ her own PAs, and transformed both her health, and quality of life. 

Robyn has used her lived experience to co-produce policy, strategy and service development with health systems and organisations for many years. She worked alongside National Voices as a Lived Experience Partner for 2 years before joining the team as Lived Experience Advisor. 

Robyn is passionate about the value of lived experience and co-production in the development of health and care services and organisations.