Dorset Integrated Care System: pilot assessment report

Assessment start date: 31 August 2023 
Assessment published: 25 September 2024

Dorset Integrated Care System 
NHS Dorset
Vespasian House
Barrack Road
Dorchester 
Dorset DT1 1TS

Introduction and overview 

Find out more about integrated care systems

Find out more about how we assess integrated care systems and the quality statements used in this assessment

CQC assessed 2 integrated care systems (ICSs) that volunteered to take part in our pilot programme. We will continue to develop the assessment process based on learning from these pilots.

Our ICS assessment team included specialist advisors and executive reviewers to contribute professional expertise, The team tested how we work with partners and stakeholders, gather evidence and work efficiently to adapt pre-existing processes to find an effective approach for assessing systems.

Using 17 quality statements from the new assessment framework as the basis for assessment, the team looked at how leadership works, how systems are integrated, progress towards reducing inequalities, and how quality and safety is managed across local services.

Dorset ICS actively engaged in this process. Our assessment found system leaders have invested in setting up the integrated care board (ICB) and integrated care partnership (ICP), building relationships across organisations. They involved local people in planning and objective setting, and have started to create the systems, structures and partnerships to create a cohesive, integrated and resilient system.

There are opportunities for Dorset ICS to progress from set-up to delivery to demonstrate impact and value for all stakeholders. There is clear desire to maintain momentum and capitalise on the energy for positive change in the system. The system will need to overcome some challenges to achieve this. System leaders recognise the risks of these barriers. There is early evidence this will lead to greater integration and more equitable allocation of resources to support safe, high quality, responsive and joined up services for the people of Dorset.

Finance

The following information is provided for information purposes only, and has not been factored into our assessment:

• Total ICB income: £909.1 million
• Total planned surplus: £0 million (planned breakeven position)
• Total deficit: £20 million (as at month six of 2023/24 financial year)
• Primary causes of overspends cited: industrial action (£3.2 million), inflationary pressures (£3.7 million), provider overspend (£15 million)

Source: NHS Dorset Integrated Care Board Annual Accounts 1 July 2022 to 31 March 2023; NHS Dorset ICB November 2023 Board meeting minutes, Dorset ICS Finance Report, September 2023.

NHS Dorset met all its statutory and administrative financial duties in its first statutory reporting period ending 31 March 2023. These are to:

• remain within its revenue, capital and running costs allocations
• to ensure cash at year end is no more than the mandated threshold.

Local context

View local context from NHS Dorset Integrated Care Board (ICB).

Local demographics

Approximately 822,000 people live in Dorset. The population profile differs slightly to the England average, with an older population structure where almost a quarter of the population is aged over 65. The population is significantly older than the England average. The population of Dorset increases in summer months when many people visit Dorset for their holidays.

The population of Dorset is generally healthier than England as a whole. Life expectancy for males in Dorset is on average 80.5 years compared with the England average of 78.7, while life expectancy for females is 84.8 years in Dorset compared with the England average of 82.8.

In Dorset, the population is generally more dispersed and low density compared with the England average. Most people are less deprived than the England average. Approximately 3% of people identify as being from ethnic minority backgrounds (compared with 13% England average).

In Bournemouth Christchurch and Poole, there is a higher population density. Population age profiles are in line with the England average. Deprivation levels are equal to the England average. Approximately 9% of people identify as being from an ethnic minority background.

Some groups of people in Dorset have poorer outcomes than others, including spending more of their lives in poor health, and dying sooner from conditions that are preventable. For example, there is a 10-year difference in life expectancy for females in Boscombe West (77.9 years) compared with West Highcliffe (87.5 years) Wards.

Although generally healthier, a higher proportion of the Dorset population has a long-term health condition or disability (19.4% compared with 17.6% for England). People in some parts of Dorset spend an extra 19 years of life in good health than people in the most deprived areas.

Both children and adults are more likely to have an emergency admission to hospital than the England average.