Promoting partnership working in the NHS

SPF Strategic Group visits to Integrated Care Systems (ICSs)

The SPF Strategic Group visited a number of Integrated Care Systems (ICSs) (formerly ACSs) to identify and understand the key issues at a local level and to help inform the next steps of any national level work.

Strategic Group members, supported by Sheree Axon, NHS England, visited Milton Keynes & Bedfordshire in October 2017, Nottingham in December 2017 and South Yorkshire and Bassetlaw in early January 2018. The main findings were:

  • Localities are at different levels of maturity in the development of local arrangements. This includes thinking on workforce issues but all recognised its importance as a key enabler to effective service change locally. How to develop a more flexible workforce who can work across traditional organisational boundaries to support patient journeys in different care settings.
  • Organisational accountabilities and responsibilities remain in place so we need to be able to work in partnership across and between organisations to help deliver more integrated services.
  • To support more integrated services and enable the workforce to work across traditional organisational boundaries we need to support the development of different resourcing models. Technical HR and other issues which need to be resolved such as development of staff passports which enable portability of things such as training, registration, employment checks, systems access and qualifications across traditional organisational boundaries.
  • All localities recognised the importance of engaging with, and communicating with, staff about their vision; to explain what they were trying to achieve and to ensure staff understood the important role they would have to play in design and delivery of local services.
  • Recruitment and retention is a major factor for all NHS (and social care) employers. Training and education is crucial to support staff to work in different ways.
  • Workforce capacity and capability in primary, community and social care is an important enabler to achieve more patient centred care which is closer to home.
  • Examples of good practice around the country streamlining project in Manchester, the work of the Partnership Forum working in Dorset and step into our shoes programme in Milton Keynes and Bedfordshire.

Next Steps

Some practical next steps are to establish a co-ordinated programme of work under the De-risking Service Change Programme:

  • Bringing together existing best practice examples from around the country to provide case study material to support localities to develop their own approaches.
  • Practical, concrete guidance on employment/resourcing models including portability and staff passport arrangements commissioned from NHS Employers. Develop a knowledge hub to capture and make available good practice and support material for workforce leads.
  • Build workforce support networks with ICS/STP areas including action learning sets supported by national organisations.

For more information, please contact the work stream lead, Sheree Axon, at or Peter Hall at