The NHS Confederation recently published research from a survey that functions as a temperature check on integrated care systems (ICSs) and the areas they are finding most challenging.

ICSs are partnerships that bring together NHS organisations and local authorities to take joint responsibility for planning services, improving health and reducing inequalities across geographical areas.

Healthcare inequalities can relate to a patient’s ability to be seen by a GP or accessing the likes of smoking cessation services.

In a survey, the NHS Confederation asked ICS leaders about their confidence in fulfilling their four core purposes – to improve population health, tackle inequalities, enhance productivity, and support broader social and economic development.

Speaking on the panel ‘How integrated care systems are tackling health inequalities’ at the NHS ConfedExpo 2024 in Manchester, NHS Confederation policy and delivery manager Ruth Lowe said: “Tackling health inequalities was the only area where no respondents to the survey felt very confident, with one in five leaders responding that they did not feel confident at all.

“What the research found was that the crucial enabler to addressing health inequalities was strong and engaged leadership.”

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This applied to those relationships within the integrated care systems, including the relationships between health inequalities leads and directors of finance within these systems to affect change.

Influence outside of this system and with the communities the respective ICS projects were seeking to serve was also highlighted as an important factor towards the success of these projects.

Lowe said: “This helped steer the Integrated Care Board (ICB) according to the priorities of local communities.”

Speaking on the same panel, the director of engagement at the Care Quality Commission, Chris Day, highlighted the need for ICS leaders to understand the effect of key drivers such as deprivation and economic disparity on healthcare inequalities.

“If an organisation is going to commit resources, time, and planning to tackle inequalities, they have to understand the implications of them,” Day said.

“There is sometimes a disconnect between the economic impact of deprivation, which is probably the least talked about, and probably one of the most important, and that the overall performance of the ICS and a focus on the short term is almost lost because the organisation doesn’t understand the wider drivers of why the wider services are operating the way that they do.”

Day concluded that bringing leadership into the conversation to understand what the key drivers of deprivation in each area, and how these are being tackled, is critical.

Reflecting on the leadership piece, Jack Lewis, public health consultant at Humber and North Yorkshire Health and Care Partnership, said that strong leadership has helped it to operationalise a sentiment across its system, including its thinking on the use of AI and its potential to aid in driving down healthcare inequalities.

“We are focusing a lot on the impact of AI in our system and thinking about the impact it could have on health inequalities and opportunities,” Lewis told Medical Device Network.