Hertfordshire and West Essex Integrated Care Strategy 2023 - 2028: Delivery Plan

1. Introduction

The Hertfordshire and West Essex integrated care strategy is an ambitious 10-year strategy which aims to achieve significant improvements in health and care outcomes for residents through a system-wide effort to tackle the drivers of poor health.

The strategy outlines how organisations within our health and care system will work in partnership to improve health and care through a sustained and joined up effort on early help and prevention.

The strategy was developed collaboratively by staff working across health and care who came together to form a multi-agency strategy development steering group. It was approved by the Hertfordshire and West Essex Integrated Care Partnership (ICP) in December 2022.

The ICP is a partnership committee, established initially by the Hertfordshire and West Essex Integrated Care Board, Essex County Council and Hertfordshire County Council, to improve health and care in Hertfordshire and west Essex. It brings together a wide alliance of organisations involved with improving the heath, care, and wellbeing of the population. Its purpose is to facilitate joint action to improve health and care services and to influence the wider determinants of health.

The integrated care strategy sets out our vision, scope, and approach. It outlines how we will work together as a system to improve the health and wellbeing of people living and working in Hertfordshire and west Essex, including increasing the years that people live in good health and reducing the gap between the healthiest and the least healthy in our community.

Our approach recognises the importance of health and care services for health, and also that health is the result of a complex interplay of factors that include our friends and family, our neighbourhood and community, as well as wider influences from education, employment, housing and other areas.

The strategy outlines how we will do things differently, whether by accelerating the pace of integration already underway or by identifying new opportunities to join up health and care. It also sets out how we will reach beyond services to join up work between the NHS and local authorities and the voluntary and community sector on other things that influence health, such as employment, housing, and education.

The strategy sets out six strategic priorities for integrated work across the system. Each priority describes the outcomes we are seeking to achieve over the first five years of delivering this 10-year strategy. The priorities are:

Priority 1 – Give every child the best start in life
Priority 2 – Support our communities and places to be healthy and sustainable
Priority 3 – Support our residents to maintain healthy lifestyles
Priority 4 – Enable our residents to age well and support people living with dementia
Priority 5 – Improve support for people living with life-long conditions, long-term health conditions, physical disabilities, and their families
Priority 6 – Improve our residents’ mental health and outcomes for those with learning disabilities and autism

This delivery plan sets out the actions we will take collectively in the next five years. We will review progress against the delivery plan on an annual basis and will prepare an annual report for the ICP with a summary of progress. We will also update this delivery plan on an annual basis.

2. Development of the delivery plan

2.1 Our approach

Our aim in developing the delivery plan is to have a single document which gives the ICP a clear overview of the priority actions for the system over the next 1-5 years.

In developing the delivery plan, we were mindful of the ICP’s decision to have four focus areas in year 1 (2023/24): ageing well and assistive technology; best start in life for children and young people; supported employment for people with learning disabilities and/or severe mental illness; and no wrong door (wayfinding) for residents to access services. These areas were chosen by the ICP because of their potential impact on health outcomes and the opportunity for scale up and joining up system working. Detailed information on the plans for each of these four focus areas is covered in separate reports that have been considered by the ICP at its meetings.

Work to develop the integrated care strategy delivery plan commenced in January 2023. It was supported by guidance and templates and developed through several system-wide briefings and workshops, and focused meetings for each priority area.

Executive Champions, who are senior leaders and members of the ICP, were agreed for each of the six priorities in the strategy. Their role is to provide leadership, assurance and oversight of actions to achieve the outcomes for their priority. Each Executive Champion is supported by between 2 and 4 Strategic Lead Officers, who are senior officers from our ICS and who have worked together as a group using their expertise and knowledge of their priority area and geography, to scope the actions needed for their priority.

Strategic leads were asked to be bold and ambitious as they identify a set of outcomes and deliverables for their priority area. They were asked to focus on the short and medium term deliverables and areas of quick wins. They were also asked to consider the added value of integration, using the opportunity for partnership working to leverage delivery or doing things differently in partnership, and placing residents and our service users at the centre of our work. Some of the actions identified are big ticket items (e.g. the proposal to develop dementia friendly communities); others are important actions which will lay the foundations for policy shifts or new services in future years; they are not headline grabbing (e.g. mapping existing services) but they are nonetheless important.

Work to develop the delivery plan was initially led by officers from Hertfordshire County Council (HCC), Essex County Council (ECC) and the Hertfordshire and West Essex Integrated Care Board. Discussions then broadened to include wider partners, and a stakeholder workshop was held in May, involving staff from the District and Borough Councils, care providers, community and voluntary sector organisations, and the four Health and Care Partnerships.

2.2 Governance

Governance has been identified for most actions in the delivery plan using existing boards and committees from our ICS system. The exception is a small number of cross-cutting areas of work where further discussion is needed to determine the most appropriate group that will have oversight. It is worth noting that we have included a mix of strategic and operational groups across our ICS geography, reflecting whether work is being delivered at the level of the ICS as a system, at ‘place’(Hertfordshire geography or west Essex geography) or more locally (Health and Care Partnerships or neighbourhoods/communities). Equally, whilst some of the groups/boards can make collective decisions for specific areas of work, we recognise that some decisions will need to be taken through each organisation’s own governance. It is therefore important that we identify the right lead organisation/s for each action in the delivery plan. Further work to refine this will take place over the next few weeks.