RCPCH response to the Hewitt review - call for evidence

In January 2023 we responded to the Department of Health and Social Care call for evidence to inform the Hewitt review looking at the oversight and governance of Integrated Care Systems in England.

Integrated care systems (ICSs) are partnerships that bring together providers and commissioners of NHS services across a geographical area with local authorities, schools and other local partners to collectively plan health and care services to meet the needs of their population. The central aim of ICSs is to integrate care across different organisations and settings, joining up hospital and community-based services, physical and mental health, and health and social care.

The Hewitt review was instigated to consider how the oversight and governance of ICSs can best enable them to succeed, balancing greater autonomy and robust accountability with a particular focus on real time data shared digitally with the Department of Health and Social Care, and on the availability and use of data across the health and care system for transparency and improvement.

Our full response to the call for evidence is available to download below.

In the response we highlight:

  • How setting clear expectations in the Health and Care Act 2022 and national guidance about ICSs’ responsibilities for children has focused attention and helped drive work for children and young people.
  • The importance of being able to easily capture and share data to improve child health outcomes and the barriers faced by services due to the interoperability of systems and the lack of a consistent child identifier.
  • The need for increased focus on children and and young people in policy frameworks and performance measurement particularly around prevention and early intervention could help ICSs deliver on their aims to improve the health of the whole population and tackle widening health inequalities. 
  • The opportunity for Integrated Care Boards to work in new ways to commission, plan and deliver more tailored, integrated and responsive models based on collaboration with a wider system and a robust understanding of the needs of their populations, for example in paediatric emergency care and mental health, where current systems are fragmented and unable to meet demand with a lack of joined up care pathways, decision-making and planning.
  • The need for a sustainable, multi-disciplinary child health workforce that supports a whole system approach, embraces new models of care and protects staff wellbeing.  
  • The importance for national bodies and local organisations to ensure that data collection systems, standards, targets and priorities consider the unique needs of children, young people and the workforce which supports them.