NHS - Integrated Care Systems – changing NHS landscape and impact on organisations

11 March 2022

Published by: Justine Turner, Senior Manager - Public Sector Internal Audit 

As the landscape of the NHS changes, the scope of the work delivered by internal auditors is changing. BDO Public Sector Internal Audit team has been involved with a number of developing Integrated Care Systems (‘ICS’), working with them as the national guidance has been issued.

There is a need to consider ways of working across the ICS in collaboration with partner organisations, in order to support organisations to understand the impact of emerging models of care, the governance and accountability implications and the interface between the statutory organisations and partnership arrangements.

Integrated Care Boards (‘ICB’) will be responsible for developing the plan to meet the health needs of the population in their area and leading the system implementation enablers to deliver this. The Integrated Care Partnership (‘ICP’) will bring together partners across the system to set the ICS strategy.

This paper highlights some current and potential risks and issues for organisation to consider from a CCGs/developing Integrated Care Boards (‘ICB’) and NHS Provider perspective, some of which are immediate and others that may evolve as new arrangements are embedded.

In particular:

  • The interface between Integrated Care Boards & Provider Collaboratives and role of individual statutory organisations
  • The impact of disruption to commissioners/providers
  • The impact on Trusts on the new ways of working
  • The coordination of the assurances required and assurance providers
  • Audit Committees considerations
  • The coordination with other Audit Committees within the ICS.

We have identified some actions for organisations to consider, for example:

  • An understanding of how the new arrangements will impact on the providers and whether a level of autonomy is removed by decision making at an ICS level
  • Establishment of key lines of accountability and robust governance arrangements for system-wide programmes within the operating model for the ICS

For further information and details of the support BDO Public Sector Internal Audit is able to provide, please download our publication below.