This research was led by Melissa Surgey as part of her MPhil. For more information about Melissa, please check our PhD Fellowships pages

 

What were we trying to do?

This project explored how health and care commissioning was changing in the reforms to health and social care in the English NHS, which reorganised health and care planning and delivery on differently sized geographical footprints. This included the introduction of Integrated Care Systems (ICSs), place-based partnerships and neighbourhood working.

 

There were three main research focuses:

 

• How place is defined and perceived by different partners in health and care
• What commissioning functions would be done where in the new system, and the rationale for this
• The accountability mechanisms that underpin the relationships between system, place and neighbourhood

 

The aim of the project was to review policy development and implementation, and provide recommendations for the future development of health and care commissioning.

 

 

Why was it important?

ICSs and place-based partnerships represent one of the biggest reorganisations of the health service in recent times. The Health and Care Act 2022 introduced significant legislative changes to how health services are commissioned, abolishing Clinical Commissioning Groups on a place footprint, and transferring their budgets and statutory responsibilities to Integrated Care Boards, which operate on a bigger, sub-regional (system) level.

 

Although ICSs and places emerged out of a long history of collaborative working in many local health and care systems, as these new organisational forms took on statutory responsibilities, the practicalities of how they would work in reality needed to be further developed. This project built on existing research into spatial organisation of healthcare, commissioning, and devolved health and care powers to fill a gap in research into these new partnerships.

 

 

How did we do it?

This was a qualitative study consisting of ethnographic case studies of two ICSs and a sub-study of a place within each of these ICSs.

 

Over 6 months, key meetings in the ICS and place governance infrastructure were observed, and this was supplemented by an analysis of key strategic documents and meeting papers.

 

Interviews with national policy-makers and influencers were completed, followed by interviewing senior leaders from different health and care partners at system, place and neighbourhood level. Interviews were analysed using thematic analysis.

 

 

Findings

Findings will be available in due course

 

 

More information

 

 

PhD/MPhil Fellow
Melissa Surgey
melissa.surgey@postgrad.manchester.ac.uk