The Hewitt Review, a recently published independent review into the oversight, governance, and accountability of integrated care systems, could be seen as a sea change moment for the healthcare and supported living sectors in the UK.
The comprehensive review, led by former Health Secretary Patricia Hewitt, was launched in November 2022 and sits at a substantial 89 pages long. That’s a lot of very dry reading, so here, we’ll dilute the vast text into five key points.
1. A shift towards Learning and Improvement
The review proposes moving away from a top-down performance management culture and fostering a culture of learning and improvement within Integrated Care Systems (ICSs). This shift aims to support ICSs in becoming self-improving systems supported by regional bodies.
2. Reduction of National Targets
One notable recommendation is to significantly reduce the number of national targets and priorities. The review suggests limiting them to no more than ten. However, it emphasises that systems would still be held accountable through local and mutual accountability mechanisms. Excessive and duplicative reporting would be streamlined, and a national peer review program, like those in local government, would be implemented. The Care Quality Commission (CQC) would assess how systems foster cultures of learning and improvement, while local council overview and scrutiny committees would scrutinise the work of ICSs.
3. Resetting National/Local Relationships
The review calls for a partnership of equals between national and local entities, shifting away from the current hierarchical approach. It suggests co-developing local priorities and giving them equal weight alongside national targets. Flexibility in budget allocations and resource rebalancing are also proposed to support this reset. Additional steps to support this reset include reducing the use of small, in-year funding pots and granting systems more flexibility in determining budget allocations within their boundaries. Resources would be rebalanced between central and regional bodies and ICSs, with a greater share allocated to the systems themselves.
4. Emphasis on Prevention
While not initially a central focus, the review highlights the importance of prevention and recommends allocating a greater share of ICS budgets towards prevention. The review recommends increasing the share of ICS budgets allocated to prevention by at least 1 per cent over the next five years and boosting the public health grant allocation. It also calls for cross-government collaboration on prevention, supported by formal arrangements. Additionally, the establishment of a national integrated care partnership forum and a new health, well-being, and care assembly is proposed to enhance engagement and coordination.
5. Uncertain Impact and Pending Adoption
The review presents comprehensive proposals but is not yet government policy. The response from ministers is a commitment to review the recommendations in the future. The extent to which these proposals will be adopted and implemented remains uncertain, particularly in terms of relinquishing central control and granting the suggested freedoms to ICSs.
The ECCO Solution
As technology continues to advance, it is crucial to ensure that integrated digital platforms, tools, and resources remain accessible, inclusive, and responsive to the diverse needs of individuals with care and support needs, including those with mental health issues, learning disabilities, older people and substance users.
These are morals the Hewitt Review is based on, and they are shared by ECCO. We believe that through continued efforts in digital transformation, we can create a more inclusive society that harnesses the potential of every individual.
ECCO has built a digital management software package designed specifically for the care and supported accommodation sectors that are engineered to make life better for the millions of people in the UK living in shared housing and the people that take care of them.
Contact us today and our team will get you sorted with a free ECCO demo and explore exactly what the software can offer your enterprise.