District councils need to be “active partners” in Integrated Care Systems, report concludes

A report produced by the King’s Fund for the District Councils’ Network has urged Integrated Care Systems to “utilise district expertise”.

The report, Driving Better Health Outcomes Through Integrated Care Systems: The role of district councils, highlighted how district councils have powers in numerous areas relating to housing conditions, local economies and natural environment, which can influence some of the most significant determinants of health.

The report said: “This means district councils are important players in areas such as managing long-term conditions, reducing obesity, improving mental health and wellbeing, combatting food and fuel poverty, assisting hospital discharge and shaping health-creating environments.”

According to the report, around 80% of the variation observed in population health outcomes is attributable to wider factors, rather than the quality of health care services.

The report notes that Integrated Care Systems (ICSs) form an opportunity to bring together the NHS, voluntary sector and local government to take action to help shift the focus from treating illness towards preventing it.

“For this opportunity to be realised in full, district councils, with their ability to act as convenors in local places, need to be active partners in ICSs,” it says.

The King's Fund found that at present, district councils’ role within integrated care systems (ICSs) had received “limited attention, with levels of integration and the strength of relationships varying between systems”.

As part of the research, the organisation interviewed district council leaders and officers and ICB employees in four case study sites: Lincolnshire; Leicestershire, Leicester and Rutland; Norfolk and Waveney; and Suffolk and North East Essex.

The report identified five principles that underpin successful involvement of district councils in ICSs:

• creating effective local partnership structures that can drive collective action on the wider determinants of health
• aligning agendas across levels within the ICS so there is a ‘golden thread’ connecting work at system level and more local partnership work
• embedding district council leadership throughout the system
• investing in relationships between partners
• building shared purpose and collective

Sally Warren, Director of Policy at the King’s Fund, said: “The need for shifting to a more preventative approach to health has never been clearer. By taking action on the wider determinants of health, integrated care systems can improve the health and wellbeing of the population and reduce the stark inequalities that exist between different communities. District councils are key allies in doing so. Our report highlights the need for district councils to be at the core of ICSs and provides practical advice about how to make the most of their valuable assets and expertise.

“In some systems, district councils are already deeply embedded within the ICS but there is a very varied picture nationally. In order to make the most of the opportunities that exist, district councils need to find shared purpose with neighbouring councils and their NHS partners and to work collectively towards these common goals.”

Matthew Taylor, Chief Executive of the NHS Confederation, said: “In the year that the NHS celebrates its seventy-fifth anniversary, it is time to recognise that for too long responsibility for the health of the population has been placed exclusively at the door of the NHS. Tragically, the decades’ long trend of rising healthy life expectancy is plateauing and for some groups declining. To address the health of the population we need a health strategy not just policies for the NHS.

“This shift requires several actions, but at the core it demands greater collaboration between organisations and across professional boundaries. Integrated care systems and the place bodies they oversee – both of which are represented by the NHS Confederation – offer the scope for new ways of working.

“This report commissioned by our partners in the District Councils’ Network from the King’s Fund highlights how district council leaders are ready to use their positions as representatives of local communities and providers of vital services to play a growing part in meeting our collective ambition for a healthier nation.”

Lottie Winson