At the system level, ICSs need to provide the digital infrastructure and strategy to support transforming care from payment by activity into an outcomes model. The future state of a joined-up care experience is still, for many, aspirational. This is a journey of continuous improvement that ICS must embrace.

People and populations within the ICS are already integrated – this evolution needs to ensure services and the infrastructure that underpins integration is too. Integrated data and subsequent intelligence aligned with a population health management approach, inside and outside of health providers, will drive capability and capacity for integrated care.

The key is integration – how the experience of receiving health and social care for a resident is joined up and seamless; each component part of service delivery aware and understanding of all service delivery partners. Each of the four levels need to be supported by scalable and sustainable infrastructure and data intelligence.

Intelligence – a core component of infrastructure

Data is an asset and a key enabler for an ICS to deliver integrated care strategies to improve population health outcomes and developing better system working. It has often been said that the NHS is ‘data rich but information poor’, a situation that could be remedied by better use of high-quality and timely data-derived intelligence. This could empower patient self-management, clinical decision making, joined-up team working, actionable insights, the identification and reduction of inequalities, coproduction, quality improvements, and ultimately improved population health.

Why is data key to the integration of an ICS?

It is important to have a baseline level of digital maturity across all organisations for the ICS to deliver more joined-up care. Although the pandemic greatly accelerated digital innovation and the use of technology by health and care providers to support care, in many areas frontline staff do not have the appropriate digital tools to provide care in an integrated manner. This hampers progress towards a seamless care experience for individuals and their families/carers.

Inconsistencies exist across individual ICSs and ICS regions, from up-to-date and enabled hardware and software systems, to antiquated systems that have inadequate functionality. How then, does an ICS rectify this and what does best practice look like? The government’s plan for digital health and social care aims to support local health and care systems to raise their digital maturity, and ensure they have a core level of infrastructure, digitisation, and skills.

The options available for embracing technology and data sharing within an ICS should include the perspective of non-NHS care providers such as care homes, hospices, domiciliary care, and the volunteer, charity and social enterprise (VCSE) sector, as they are both contributors and consumers of data and intelligence. VCSE organisations (such as Age UK and the British Red Cross) perform a significant service to residents across many footprints and access to a shared care record would help streamline assessments and joined up delivery across the care continuum.

Ways to support data integration across an ICS

An ICS digital strategy needs to consider the use cases for real-time, safe, and effective decision making at the point of care as well as near real-time intelligence to support prevention and proactive care. It also needs to accurately map the interfaces between service providers at stages of the patient/service user’s journey to understand the data needs – then develop the data strategy and procure the infrastructure from person to system level to support integration.

The ICS must also establish clear and robust system level management arrangements for information governance (IG). These should enable partners to put the data that they hold to best use to provide efficient and effective care to individuals and using anonymised information to inform clinical and operational leaders at all levels of the ICS (system, place, neighbourhood and individual).

An outline of the ICS vision of how digital and data enables them to meet their vision and mission for the ICS can also support integration. The ICS digital maturity assessment can provide a joint understanding for where an ICS is in its digital enablement journey in order to plan and prioritise its focus and resources.

For its part, the NHS should continue with the development of a digital shared care record for every resident and enable people to have access to their own digital health and care records. The NHS App will be the front door for all provider health care portals a resident is registered with and is designed to be secure for the person.

It is a requirement of an ICS that partners listen consistently to, and collectively act on, the experience and aspirations of local people and communities. An inclusive engagement process actively involves disadvantaged communities and ensures mitigations are in place to prevent unintended consequences such as a digital divide. Engagement should include a variety of channels for residents to ask questions, comment on care experience and provision, and participate in codesign and coproduction opportunities.

Finally, it is important for an ICS digital strategy to have a shared care plan for every resident represented within the ICS at its heart. This has been talked about for some time; the technology is there but what is needed is the drive, governance, policies, workflows, and workforce to operate in such a way that this can be deployed and utilised.

Data as a core component of infrastructure and the intelligence derived from it is a key enabler in an ICS being able to achieve their ambition of delivering integrated health and social care, providing a seamless care experience for their populations. Integrated data will completely transform the way care is planned and delivered at each level of the ICS – system, place, neighbourhood and person – with an impact on health inequalities and population outcomes that we’re only just beginning to realise the potential.