How much progress has been made with the NHS Long Term Plan delivering integrated care?

Hundreds of mental health patients being admitted to private wards far from home.

Steve How and Paul Midgley, of Wilmington Healthcare, track the progress of NHS England’s diverse local health economies in delivering integrated care.

The recently published NHS Long Term Plan states that, by April 2021, all areas of England will be covered by an Integrated Care System (ICS), with typically one clinical commissioning group (CCG) per ICS area.

Currently, however, there is huge variance in the way that local health systems are being run across England, with some areas leading the way in ICSs; while others are in financial recovery and at the start of their integrated care journey.

Even within the first wave of 14 ICSs, there are different levels of sophistication, with a handful of the most advanced systems having dispensed with standard Payment by Results (PBR) contracts and operating more integrated budgets.

These highly advanced ICSs are the beacons of excellence which all other health systems are under pressure to emulate within the next few years.

Mapping regional variants around integrated care, understanding how the needs of local health systems differ and keeping abreast of change over the next few years, will be of paramount importance for the pharmaceutical industry.

For Sustainability and Transformation Partnership (STP) customers that will become ICSs in the next couple of years, pharma needs to identify the clinical leaders tasked with making it happen. Although industry needs to be mindful that reducing direct costs will still be a priority for these organisations, reducing system costs across the whole pathway is the driver for change.

Most ICSs are at the point where they are preparing to deliver fully integrated holistic care and for these customers pharma needs to identify where transformation is occurring and define how that aligns with its own workstreams and wider ICS priorities, such as frailty.

When engaging with the very small number of highly advanced ICSs that already have fully integrated budgets, pharma should consider instigating top level discussions involving its chief executive or managing director to define the wider value that the company can deliver. Such discussions should be held in addition to deploying sales staff to engage at clinician level on products and how they fit into care pathways.

The individual plans that local health systems must prepare for NHS England in response to the Long Term Plan will provide useful insights for pharma and information about them should be found in draft board meeting minutes published in March.

A number of documents, such as the primary care network contract, have also recently been published by the NHS which detail how certain aspects of the Long Term Plan will be delivered. Pharma must keep abreast of these changes and ensure that its engagement strategy is tailored to support the diverse needs of individual health economies.

For more information on pharma, the NHS Long Term Plan and integration, click here.


Steve How and Paul Midgley are part of Wilmington Healthcare’s Consulting Team.

For information on Wilmington Healthcare, go to


Read the full magazine here: April Pf Magazine