In February, we announced our work with National Voices and the Point of Care Foundation on a Regulators ' Pioneer Fund project.
The project aims to develop an improvement framework for integrated care systems (ICSs) to understand how well their engagement with people and communities is helping to reduce health inequalities. Through focusing on local communities, understanding what people need, and what is working, ICS can improve services and reduce health inequalities for the people they serve.
The project has 3 distinct phases: scoping, co-design, and testing. We now share the progress on the first 2 phases.
Scoping phase (February to May 2024)
A review carried out by the Point of Care Foundation focused on existing practice in engaging with people and communities to address health inequalities. This involved examining various case studies and existing frameworks to provide a comprehensive analysis to inform the development of the improvement tool and the co-design workshops.
National Voices carried out interviews with 4 ICSs, to get a better understanding of the good practice examples and of how such engagement frameworks are being used in practice. The interviews highlighted the limited application of existing tools to date. This is largely because ICSs are still relatively new and are operating in a challenging environment while continuing to prioritise and maintain long-standing relationships and community engagement. Read the existing practice review.
Co-design phase (April to July 2024)
The co-design phase of the project has demonstrated the effectiveness of engaging a wide range of stakeholders. This includes with VCSEs, representing key communities affected by health inequalities, as well as people with lived experience. The framework has been developed by seeking continuous feedback and using workshops to gather insight from discussions with the people an ICS has engaged with, to ensure that it leads to meaningful change. This co-design phase has been overseen by an Expert Advisory Group, co-chaired by Jacob Lant, Chief Executive of National Voices and Robyn Chappell, Lived Experience Advisor at National Voices. The conversations held by and as a part of this group have been fundamental in ensuring that a diverse range of viewpoints and experiences feed into the development of the framework, to understand how they have shaped the program, read this blog.
Involving stakeholders
We have heard from people and organisations across health and social care, including NHS representatives at local and national level, local government, think tanks, professional bodies, voluntary and community sector enterprises (VCSEs), Healthwatch England, people with lived experience and ICSs. This feedback has helped us understand more about the need for clear decisions to enable ICS engagement to lead to meaningful change.
Developing the draft framework
The draft framework has been designed to meet the needs of ICSs through co-design. It includes different phases and domains and allows an ICS to focus on specific areas and critically reflect on how it is engaging across each phase.
Next steps
The next stage of the project is the testing phase. The draft framework will be tested in the autumn of 2024 with 4 voluntary ICSs. These were selected as they have a mix of demographics, geography, levels of deprivation and experience in addressing health inequalities. The are:
- Black Country ICS
- Gloucestershire ICS
- Hampshire and Isle of Wight ICS
- Nottingham and Nottinghamshire ICS
We will use the learning from the testing to adapt the framework and help develop guidance and learning materials for ICSs to help them to use it. The learning will help us to ensure the tool is practical for ICSs to use and has an impact for people and communities experiencing health inequality.
The framework and accompanying guidance will be launched in Spring 2025.
Chris Day, Director of Engagement at CQC, said:
“I am pleased to see how much progress this project has made and I look forward to seeing the results of the testing phase due to start soon. The framework has been co-designed with a wide range of stakeholders and people with lived experience to ensure it is informed by their insights and experiences. The framework will support ICSs to better understand how people access and experience care, and inform how they use this to improve outcomes and reduce health inequalities. This is what matters to people accessing and using services.”
Jacob Lant, Director of Engagement at National Voices , said:
“We have really valued the opportunity to work on this important project with the CQC and the Point of Care Foundation, and want to extend our thanks to the Regulators Pioneer Fund for investing in this.
By ensuring that this framework is co-designed with a range of people and organisations, and especially with those who have lived experience, we are hopeful that it will succeed in its overall goal of supporting integrated care systems to work in true partnership with those experiencing health inequalities.
When people and communities feel they are having meaningful input into decision making and guiding improvements, ICSs will be able to realise their true potential in helping to tackle health inequalities.
We are excited to move on to the testing stage of this project and look forward to providing further updates.”
Sarah Massie, Director of Programmes at the Point of Care Foundation, said:
"We are delighted with the progress of this project and excited to be entering the testing phase. We're grateful to the four ICSs – Black Country ICS, Gloucestershire ICS, Hampshire and Isle of Wight ICS, and Nottingham and Nottinghamshire ICS – for volunteering to test our framework. This will help us continue to co-design the framework to be as effective as possible in reducing health inequalities. It is our hope this project will help develop truly inclusive and compassionate services by working directly with communities."
For further information on the project, please contact ICShealthinequalities@cqc.org.uk
Regulators' Pioneer Fund (RPF)
The Regulators ' Pioneer Fund (RPF) is a grant-based fund to enable UK regulators and local authorities to help create a regulatory environment that encourages business innovation and investment. The current £12m round is being delivered by the Department for Science, Innovation and Technology (DSIT).