Assessing progress in managing and improving quality in nascent ICSs in England

In 2022, England embarked on a bold journey of healthcare transformation, aiming to create a unified health and care system that prioritises the wellbeing of its population. These newly established Integrated Care Systems (ICSs) set out to enhance the quality of care, seeking to deliver the best possible outcomes for individuals and communities through the provision of evidence-based services. At the heart of this endeavour lies the Quality Management System (QMS) framework, an emerging approach for quality management in organisations.

Picker and wider colleagues in the Quality, Safety and Outcomes Policy Research Unit undertook a project to examine how ICSs are navigating the intricacies of quality management. For the research, four ICSs were carefully selected, collecting data between November 2021 and May 2022, and over 60 system leaders across health and social care, public health, and local representatives were engaged with, conducting semi-structured interviews. Additionally, key ICS meetings were observed and pertinent documents scrutinised.

The findings shed light on the priorities of these ICSs, which prominently include improving population health, reducing disparities, and enhancing accessibility to healthcare. This marks a noteworthy shift away from the traditional clinical approach to quality. However, it also uncovered a noteworthy tension between quality assurance and improvement within these systems. There were concerns that an excessive focus on assurance might hinder ICSs from addressing broader quality issues, such as addressing inequalities and unwarranted variations in care and outcomes. Partnerships emerged as a crucial enabler for integration and were viewed as integral to achieving quality improvements. In sum, ICSs expressed concerns about the potential challenges they face in advancing quality development.

To delve deeper into the study’s insights and findings, please access the full publication on Sage Journals.