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ICS Integration & Innovation Leaders’ Forum
Lord James O'Shaughnessy, Former Minister for Innovation at the Department of Health and Social Care
Angela McFarlane, Vice President, Strategic Planning Northern Europe, IQVIA
Jul 27, 2022

Gathering in person for its inaugural meeting, a diverse and senior NHS leadership group gathered for the inauguration of IQVIA’s ICS Innovation and Integration Leaders’ Forum in Liverpool on 14th June. After two very difficult years for everyone involved in health and care, and despite existing pressures, there was great energy in the room about the opportunities presented by the innovation and integration agenda.

Chairing the session, Lord O’Shaughnessy welcomed founding Forum members and explained the purpose of the IILF, to bring together leaders from across England to explore how innovation, in all its forms, could be used to deliver on the promise of integrated health and care. Angela McFarlane, Vice President, Strategic Planning, Northern Europe, IQVIA, , also welcomed the group, explaining her vision for the Forum as a peer-to-peer network for collaboration, creating head-space for innovative thinking and sharing experience and best-practice. Angela also headlined thought leadership, health data insights to support NHS recovery and local service transformation, clinical pharmacy support, research and RWE expertise that IQVIA could provide the Forum going forward.

After Forum members introduced themselves, five speakers were invited to share short ‘provocations’ from their point of view, about the integration agenda and how harnessing innovation could help:

  • Catherine Pollard, Director of Tech Policy at NHSE/I asked the group: ‘how do we harness NHS data, technological advancements, and commercial pathways to achieve innovation in healthcare? Achieving innovation in these areas is difficult, yet the Covid-19 response shows we can do it: regulators, industry and policymakers can align to produce incredible health outcomes at scale.
    • So how do we bring all data together at scale so it can provide the platform to support innovators. How can it be shared across health sectors?
    • How do we create a reimbursement pathway for digital alongside medicinal solutions, especially when value for money – expressed through time saved as well as money saved – is so important?’
  • David Flory, Chair of Lancashire and South Cumbria ICS, noted the reality that ‘as a sector we will be judged on the progress we make in reducing variation in outcomes. There is a need to be “fast out the blocks” in delivering integration between health systems – we need to address short-term deliverables, such as better primary care access, quickly. To achieve this, requires ways of working – bringing people with expertise around the discussion table to find these solutions and apply them.’
  • Richard Stubbs, CEO of Yorks & Humber AHSN, talked about the importance of real-world evidence in supporting innovation, asking ‘how can we trust each other and our evaluations to promote collaboration among systems? There is a tendency within the health system to try and solve problems in silos, and health providers need to be more unified in their approach’. Richard explained ‘we cannot implement innovation at scale without the support of the private sector. We need to adopt innovations and stop the best people from going overseas to more favourable environments and systems with higher adoption and uptake’.
  • Martin Gibson, CMO of North-West E-health (NWEH): Embedding Research in ICS Strategy explained the 10-year timeframe from discovery and development to regulators and appraisal, listing the challenges along each phase. ‘Implementation is hard and should draw on science to addresses the translation gap to account for the complexities of working in multiple settings’. He highlighted several studies that had used data to promote innovation, including the SPLINT study (nurse-led hypertension and lipid management targeting improved blood pressure and cholesterol management in a population with diabetes) and the PACCTS study (telephone-based support of lifestyle and behavioural change to improve glucose control in people with type 2 diabetes). Martin also talked about how research (the SPIRIT Trial) is being used to promote the use of Inclisiran within primary care, as part of a national programme, and how NWEH has developed FARSITE – a tool for finding and recruiting patients directly via GPs for research and health improvement initiatives. Despite the success of all these studies embedding and implementing the learning from them has been hard, and the innovation they showed is still not fully implemented. Proof that there is a need to not only provide the evidence for change, but find new ways of ensuring implementation of innovation can be delivered at both pace and scale.
  • Arlene Neville, Head of Transformation for the Leicester, Leicestershire and Rutland (LLR) ICS focused on her local system’s approach to long term condition recovery. ‘Through COVID-19, the disruption and displacement of proactive care for people living with CVD-R long-term conditions will likely result in exacerbation and complications for patients. This could add further waves of demand for unscheduled care over the coming months in primary care, emergency and hospital admissions. As a solution, LLR is working with trailblazer PCNs & GP Practices to support proactive care at home to support the restoration and reset of long-term condition management across all 25 PCNs. Practices and PCNs have asked for “arms and legs” to help them manage their backlog, so LLR commissioned two independent sector companies, Interface and MMS, to deliver through teams of clinical pharmacists LTC reviews for practices. The contracts lasted a total of seven weeks from 14th February 2022 to 31st March 2022 and managed to deliver 76% success rate. This was an ambitious project not least because the Board hade to be convinced that the NGS on its own could not deliver the capacity needed to undertake the reset of LTCs, and that collaboration with the private sector to create this much needed intervention was the right thing to do'.

Following the introductory presentations, the meeting was broken into two groups to discuss implications, to share their own experiences, and to discuss future priorities for the Forum. The main topics of the discussions included:

  • The need for a sense of ‘pull’ from the system to create the same sense of mission and urgency in the big missions for the NHS Recovery when they can’t have everyone stop to attention.
  • A change of culture so that local leaders with the know-how to operate do not need to feel they need permission from the centre to innovate.
  • A much greater focus on sharing progress and lessons from innovation across systems as well as inside systems.
    • Great work is often being done but is left on its own and not shared or embedded.
  • Much greater focus on addressing health inequalities is needed if ICSs are going to justify their existence.
    • The ability to influence policy and practice across many public services, not just health, needs to be fully exploited to deliver this.
  • Following this, local government and social care need to be more prominent in the local debate. There is a risk that the integration agenda is dominated by the NHS. From the Forum’s perspective, it needs system leaders from LA’s, including social care.
  • ICSs should be given an explicit focus not just to promote research but to measurably increase levels of activity in both R&D and innovation. New metrics on the amount of time and money dedicated to innovation & R&D, and new responsibilities on boards, are needed.
  • Time savings can be the common currency for innovation across the board, not simply saving money.

Drawing the session to an end, Lord O’Shaughnessy & Angela McFarlane thanked the Forum members for an outstanding and invigorating discussion.

Future meetings of the Forum will take place in the Autumn and priorities for further work identified in the discussion were to be disseminated in the coming weeks.

This short report captures the inauguration discussion of the ICS Integration and Innovation Leaders Forum and the key themes we would like to continue to discuss moving forward:

  • Reducing health inequalities and disparities
  • Building data analytical capabilities in order to deliver better population health management
  • Reforming governance and accountability regimes to promote innovation and R&D

If you would like to participate and join the Forum discussions or would like to discuss the three themes above, please reach out to Manesha.banwait@iqvia.com

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