One year after the Hewitt review of integrated care systems (ICS), NHS Confederation has published an insightful exploration of progress against the review.

Whilst progress has been made, in reading the report I was struck at the seismic change required in leadership behaviours, style and approach across ICS’s to realise the goals of integration, devolution, digitisation, and greater resource reallocation towards prevention to improve health outcomes and ensure the NHS’s sustainability.

🔭 Adopting a Long-Term Vision: Leaders must shift from short-term fixes to long-term strategic planning. This involves embracing preventative measures over reactive treatments, which requires patience and persistence.

👨‍👩‍👦‍👦 Enhancing Collaboration: Effective integration demands collaboration across various sectors, including local governments and voluntary organisations. Leaders need to foster a culture of partnership and shared goals.

💡 Embracing Innovation: Devolution and local accountability call for innovative approaches tailored to specific community needs. Leaders should encourage experimentation and be open to new ideas, even if it means deviating from traditional practices.

📊 Data-Driven Decision Making: The move from analogue to digital necessitates a robust understanding of data integration and usage. Leaders must champion the adoption of new technologies and ensure their teams are equipped to handle these tools.

 For these to be delivered, be it individually or collectively, will mean a number of challenges will need to be addressed

💪 Resistance to Change: Senior leaders and managers often find it challenging to break away from entrenched practices. Overcoming resistance requires a concerted effort to highlight the benefits of new approaches and provide support during the transition.

Balancing Accountability and Autonomy: While greater autonomy is essential for local innovation, it must be balanced with accountability. Leaders need to develop transparent metrics for success and ensure they align with broader national goals.

💷 Resource Constraints: Implementing the Hewitt review’s recommendations demands significant resources. Leaders must navigate funding limitations and advocate for the necessary investments to drive change.

🧠 Cultural Shift: Creating a culture that prioritises prevention over treatment involves changing deeply ingrained attitudes. Leaders must lead by example, demonstrating a commitment to preventative measures and fostering a mindset shift within their organisations.

And all of this is before we even consider short term external pressures that are likely to impact on longer term planning.

We can continue to shout for (much needed) funding uplifts but of equal importance is the need to ensure we have senior leaders and managers who are willing and able to adapt their behaviours and mindsets and stakeholders that have realistic expectations and are prepared to be patient.