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Environmental Audit Committee accepts PPP evidence submission on AgriTech

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Agritech

Experts have called on the government to re-assess approaches to the development and application of agricultural technologies or risk failing to decarbonise the sector.


Key findings

  • Recommendations of new PPP report accepted in the Environmental Audit Committee’s call for evidence on environmental change and food security
  • Report calls for AgriTech to become an area of priority in the net zero transition  
  • AgriTech will play an essential role in decarbonising the food system, and supporting a green transition in other sectors   
  • Experts gathered to call for a revamped approach to innovation and implementation within the agriculture sector  

Innovation in the food supply chain: Unlocking AgriTech for net zero, sets out a series of recommendations for the government to achieve its ambitions of decarbonising food production, while also improving food security and delivering net zero across the UK by 2050.   

The findings of this report, published in partnership with Bayer Crop Science and the Agri-EPI Centre, have been accepted as evidence to The Environmental Audit Committee’s inquiry into environmental change and food security (Environmental Change and Food Security: call for evidence). 

A version of this report was submitted in response to three key questions from the Committee’s call for evidence:

  • Does the government’s Food Strategy put the UK on a path to a secure and sustainable food supply?
  • What role do food technologies have in mitigating the risks that environmental changes poses to UK food security?
  • Is there research and development the government could be funding to provide food security solutions?

Accordingly, PPP’s submission highlights the need for a revision to AgriTech innovation and implementation processes in order to meet the ambitions of improving food security and nutrition while reducing emissions from agriculture, as set out in the Government’s Food Strategy. PPP have called for government to provide greater clarity on the sector’s priorities, and to revise trialling requirements to improve the efficacy of innovation processes. The report also highlights the importance of improving data collection and analysis in order to provide a more complete picture of the impacts of mitigations and adaptations.   

The full version of the 41-page report, containing 14 recommendations, also highlights the important role of consumers in innovation pathways and offers suggestions to improve trust between them and the sector.  

The UK government has set forward the ambitious plan of delivering net zero by 2050 and doing so while increasing the quality and quantity of agricultural production. The NFU has pushed for an even more progressive target, aiming to reach net zero emissions in English and Welsh agriculture by 2040. The report argues that these ambitions will not be achievable unless the UK is able to improve the efficiency of the processes that deliver emissions-saving technologies to farmers.   

Independent research undertaken by NFU Mutual in 2022 found that nearly half of farmers chose not to invest in AgriTech because of a ‘lack of knowledge’. Improving departmental coordination and providing clarity to the supply chain will require a clear plan for AgriTech’s development, which the report argues does not currently exist. Closer collaboration will enable a more fluid and consistent exchange of knowledge in the sector, which the report finds to be a key determinant of AgriTech support.   


Quotes:  

Mark Buckingham, Corporate Engagement Leader UK & Ireland, said: “Innovation in breeding and genetics is essential to both reduce the carbon footprint of food production and give farmers a choice of seed varieties which can grow well in a changing climate.”  

Mr. Buckingham also noted: “Faced with climate change, it’s vital we don’t miss opportunities to decarbonize, protect nature and deliver safe affordable food; regulation needs to be proportionate and enable, rather than block, access to innovation.”  

Dave Ross, Agri-EPI, CEO, said: “Net zero is the ultimate ambition and the agri-food supply chain must play its part in both reductions, and sequestering carbon back while supporting food security. The report rightly recognises the lifeblood of innovations require resources and partnerships with our industry base, linked with key knowledge partners. We fully support the recommendations to continue and indeed increase this support, to meet the challenge of future GHG reductions. We are grateful for the opportunity to co-sponsor.”  

Trish Toop, Chief Technical Officer, Agri-EPI said: “Precision engineering solutions and data have a role to play in supporting the journey to net zero. In our recent AgriTech survey, which is highlighted in the report, found that over 60% of UK farmers believed AgriTech solutions will aid their sustainable productivity, but some farmers were not clear about specific net zero benefit. So there, is work to be done still, to provide this evidence and support.”  

Simon Pearson, Professor of Agri-Food Technology and Director of Lincoln Institute for Agri-Food Technology, said: “The global AgriFood supply chain emits up to 37 per cent of all global greenhouse gas emissions, including 43MTCO2e from UK primary agriculture. At the same time society is facing exceptionally high food price inflation. The food sector needs to urgently step change its economic and environmental productivity. This PPP report is essential reading, with clear strategies for how the UK can step change and secure its position as world leaders in agricultural technology.”  

Innovation in the food supply chain: Unlocking AgriTech for net zero is a part of PPP’s net zero programme. The full report can be read here.  


Key recommendations from the report include:    

  • The National Science and Technology Council should include the Secretary of State for Environment, Food and Rural Affairs, and should seek to evaluate the impacts of continued AgriTech investment in the context of the UK’s broader net zero ambitions.   
  • UKRI should seek to support the development of key products through the creation of Small Business Research Initiatives (SBRI). These initiatives would seek to finance solutions to specific blockers currently problematising the decarbonisation of the UK’s food system.   
  • The AHDB should be encouraged to establish a single What Works Network to monitor the effect of policy and practice on farming and diets. Though this single centre would be tasked with tracking a broad range of impacts, a single centre for the assessment of policy would help to break down silos within the sector and would encourage policymakers and industry to better represent the relationship between the production and consumption of food.   
  • Defra should embed novel data collection, sharing processes and requirements into environmental land management schemes – thereby streamlining reporting processes and providing clarity for data capture for farmers.   
  • Working with the FSA, Defra should establish a series of case studies to encourage support of the Food Data Transparency Partnership as a decentralised library linking data collected from throughout the supply chain. Key insights gleaned via the Food Data Transparency Partnership should be made available on centralised libraries such as the AHDB’s planned What Works Centre.   
  • The Rural Payments Agency should seek to establish a carbon credit scheme for farmers driven by the insights reported through environmental land management schemes. This would ensure farmers see clear benefits to increased reporting and implementation. Credit trading, however, should be closely monitored to ensure that agricultural production is maintained and not disincentivised.   
  • The UKRI and BBSRC should establish new guidance for the trialling of novel AgriTech products, such that they encompass metrics pertaining to sustainability value alongside more traditional metrics. A National AgriTech Trialling Advisory Group should be temporarily created through UKRI and BBSRC, in conjunction with the Advisory Committee for Releases to the Environment (ACRE), to inform stakeholders of updates to the process of getting new products into trials under updated regulation.   
  • Considering Defra’s success in establishing a consistent definition for precision bred organisms, the department should continue to review inherited regulation of other technologies currently restricted by the regulation of GMOs.   
  • Defra should publish revised labelling guidance for retailers to encourage greater consumer awareness of the sustainability impacts of products. A timeline for the integration of kg CO2e cost (per tonne or kg) data into labels should be developed.  

 

 

 

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New report calls for DHSC to do more to bring digital transformation to care sector

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A new report by Public Policy Projects (PPP) has outlined a series of measures for government, care providers and key stakeholders to digitally transform the social care sector.


Key findings

  • Key social care experts have called for more positive engagement for digital suppliers as social care continues to lag behind other key sectors in digital transformation.
  • The uptake and impact of digital technology in social care remains uneven, reflecting the fragmented nature of the sector.
  • PPP puts forward a series of recommendations for key central organisations (such as DHSC, NHS and CQC), as well as for local authorities and integrated care systems, to support and prioritise digital transformation in social care.

 

PPP’s new report comes amid unprecedented service pressure and demand across health and care, in part caused by a fragmented care sector that has yet to fully harness digital tools to transform care delivery.

Among the report’s key recommendations are calls for the Department of Health and Social Care (DHSC) to establish a new board and forum for all stakeholders involved in the digital transformation of the care sector. The forum and board, designed to mirror similar structures DHSC currently uses for its rare diseases engagement, will facilitate better communication and help improve understanding of the use of technology within a currently fragmented care sector.

The report, A care system for the future: How digital development can transform adult social care, is chaired by former Deputy Prime Minister Damian Green MP and Senior Advisor to Care England, Daniel Casson. It provides a set of recommendations for DHSC, NHS, ICSs and local authorities to enable more effective digital transformation across the care sector, encouraging greater usage of digital social care records (DSCRs), the shared care record (ShCR), assistive technologies, improving workforce capabilities and discouraging digital exclusion among those in receipt of social care.

The Covid-19 pandemic prompted significant digital transformation is occurring across social care, but this transformation still lags behind other comparable sectors and the NHS. However, the fragmented nature of the sector, with its thousands of individual care providers and competing digital suppliers, makes widespread transformation more challenging – meaning that the benefits of digital transformation are not being felt evenly.

A care system for the future highlights the need for increased usage of DSCRs across all care institutions, particularly for domiciliary care. Consistent digital social care recording will also aid the integration of health and care within ICSs via the ShCR. Once all social care providers can connect to the ShCR, more holistic, ICSs can enable more joined up and better-informed care provision.

PPP are also calling for DHSC to provide better support and encouragement for DSCR providers not currently on the NHSTD Assured Provider List, and for greater discussion of how best to ease the burden for health and care providers operating across multiple ICSs borders.

The report calls for individuals in receipt of domiciliary care to be encouraged to direct more of their personal budgets and direct payment allowances to procure assistive technology, which can increase independence and reduce the need for in-person carers where appropriate. To facilitate this, local authorities should produce a comprehensive guide of the available assistive technologies, so that individuals can make informed decisions about which technology to procure for their homes.

PPP’s report also emphasises the necessity of improving digital skills among those in receipt of care, in order to maximise the impact of digital technology in social care. Older and disabled people are among the most likely to be digitally excluded, often contributing to social isolation, loneliness and various associated poor health and wellbeing outcomes. Improving digital communication skills, allowing those in receipt of care to communicate with friends, family and others with shared interests, will improve the loneliness epidemic among older and disabled people in the UK.

In order to help maximise staff engagement with technology, A care system for the future stresses the importance of design simplicity. Additionally, the report calls for all care professionals to undergo basic digital training to upskill the workforce with basic digital skills to use electronic care recording, the most common assistive technology, and communication technology, as well as to undertake basic data collection.

The report also calls on DHSC to reconfigure and re-market the Care Workforce App, first launched in 2020, to connect and support the disparate care workforce.


Commenting on the report:

The Rt Hon Damian Green MP, Former Deputy Prime Minister and Chair of the report: “Digital transformation across the care sector is occurring rapidly, bringing with it efficiencies and benefits that can improve quality of care. However, when applied incorrectly, digital tools and systems can alienate people in the sector and cause them to disengage with care technology and lose out on potential benefits

“This report contains several practical proposals which will ensure that the digital tools implemented across the adult social care sector will enhance the professional and personal lives of those impacted by the care system and improve the quality of care provided.”

Daniel Casson, MD of Casson Consulting (Encouraging Innovation in Social Care), Advisor to Care England said: “To give our system the best chance of supporting people we need to promote digital technology. We need to promote it to give people as much independence as possible and to free up carers (both professional and unpaid) to use their skills and time to enhance people’s lives.

“Digital transformation can provide value for people, for organisations, and for the health and care system, if we target it correctly. This report has nine very clear recommendations which give much food for thought.”

For more information on PPP’s social care policy programme, please contact Mary Brown at mary.brown@publicpolicyprojects.com.

Download the report here.

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ICS Roadshow draws to a close as PPP announce ‘Delivery Forum’ for 2023

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ICS Delivery Forum

PPP’s integrated care policy programme enters a new phase as the ICS Roadshow draws to a close, following five successful conferences held across the country. The policy institute will now seek to build upon the legacy of the Roadshow and launch the ICS Delivery Forum.


 

The Roadshow provided a unique opportunity for health and care stakeholders to discuss the challenges and opportunities of integrated care at a localised level. The events successfully brought stakeholders together with ICS leadership and provided a platform for the next generation of health and leaders. They also allowed local people to gain an intimate understanding of what integrated care means for them.  

Each Roadshow event saw ICS leaders and a broad spectrum of health and care stakeholders come together for discussion and debate in five cities: Leeds, London, Birmingham, Manchester and Bristol.  

Topics of discussion included: 

  • Ensuring ICSs come to represent a ‘partnership of equals’ between different parts of the health and care system 
  • Considering data sharing as a duty of care 
  • Prevention, early access and health inequalities 
  • What does ‘good’ look like for integrated care?  

Speakers included: 

  • Sir Richard Leese, Chair, NHS Greater Manchester Integrated Care 
  • Frances O’Callaghan, Chief Executive, North Central Integrated Care System  
  • Pearse Butler, Chair, South Yorkshire ICB  
  • Dr Tracey Vell MBE, Associate Lead for Primary and Community Care, NHS Greater Manchester Integrated Care  
  • Dr Jeff Farrar, Chair, Bristol, North Somerset and South Gloucestershire ICB  
  • Vic Rayner OBE, Chief Executive, National Care Forum  
  • Sarah Price, Deputy Chief Executive / Chief Officer for Population and Health Inequalities, NHS Greater Manchester Integrated Care  
  • Professor Debbie Stark, South West Regional Director, Office for Health Improvement and Disparities, NHS Regional Director of Public Health  
  • Dr Masood Ahmed, Associate Chief Clinical Information Officer, NHS Midlands  
  • Dr Justin Varney, Director of Public Health, Birmingham City Council  
  • Mandy Clarkson, Deputy Director of Healthcare Public Health, NHS Midlands  
  • Christiana Melam, Chief Executive, National Association of Link Workers

What was said: 

Speaking at the Roadshow in London, Frances O’Callaghan, Chief Executive of North Central London ICB said: “The situation has never been as challenging as it is today. However, when I first joined the NHS, we talked about waiting lists. We always talked about money, but we didn’t talk about population. We didn’t talk about levels of deprivation, we didn’t talk about economic insecurity, we didn’t talk about housing. We provided a service and hopefully, the people came. It’s not like that anymore.”  

Yousaf Ahmed, Chief Pharmacist for Frimley ICB said: “ICSs need to win hearts and minds if they are to be a success. If I went to my local trust hospital and asked a band, five or six nurse, what is an ICS, they would look at me blankly. There are many people within our organisations, our providers and our systems who can’t fathom what an ICS means to the individual.”  

Speaking in Manchester, Sir Richard Leese, Chair of Greater Manchester ICB said: “In many ways, the ICB is the least important part of an ICS as this is not where the crucial work takes place. The key ingredient to integration is bottom up, locality and place-based care. About half of Greater Manchester now has wholly integrated adult social care with primary care operating on a neighbourhood basis.”  

Speaking in Bristol, Dr Jeff Farrar, Chair of Bristol, North Somerset and South Gloucestershire ICB said: “The ICB is not there to performance manage every part of the system, the ICB is a collective of all of our partners, not a separate organisation…unless we manage performance collectively, we will continue to do the same things we have always done.” 

Speaking in Leeds, Pearse Butler, Chair of South Yorkshire ICB said: “It’s inconceivable that we can provide really high-quality services…unless we integrate in a way that we traditionally haven’t done.” 

All the key findings from the ICS Roadshow will be made public in a special insights report, to be published at the start of 2023. For more information on this, please contact david.duffy@publicpolicyprojects.com.  

We are grateful to each of our ICS Roadshow partners: Deloitte, NHS South Central West, Insource Ltd, Palantir, Oracle Cerner, Tunstall Healthcare, Radar Healthcare and Novartis.


The ICS Delivery Forum 

As integrated care systems (ICSs) evolve their service offering, PPP will develop its ICS policy programme. With the ICS Roadshow ending, PPP has announced that the second phase of its integrated care policy programme will centre around an ICS Delivery Forum.  

The Delivery Forum builds on the foundations of the Roadshow, continuing to connect key health and care stakeholders at a localised level for vital discussion, debate and networking. However, the Delivery Forum will focus on developing impact driven, results-orientated insights.  

Working in close collaboration with ICSs and crucial providers, PPP will create a programme that highlights exactly how ICSs are making place based, personalised care a reality and the impact this is having on individual citizens.  

Rather than discuss issues such as health inequalities in broad framing and terminology, the Delivery Forum will ask local systems leaders and stakeholders to demonstrate exactly how integrated care systems can affect change in key health and care challenges.  

The Delivery Forum will also provide a helping hand to ICBs grappling with workforce challenges and service pressures by connecting system leaders with on the ground innovators and industry experts.  

If you have insight, solutions and case studies that can benefit health and care providers and can help guide ICSs onto their next phases of transformation, please contact lee.davies@publicpolicyprojects.com. 

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UK government must deliver its promises for carbon capture storage

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carbon capture storage

New PPP report calls upon the UK government to deliver on immediate plans for CCS, develop engineered carbon dioxide removals to put the ‘net’ into net zero and build a world-class UK supply chain with sustained future deployment.  


 

A new report from Public Policy Projects (PPP) is calling on the UK government to focus on the implementation of carbon capture storage (CCS) projects to meet its net zero targets and finds infrastructure as the key physical enabler for industry to progress. Several European countries have increased their attention on CCS during the past year and have made significant progress. Without swift and rapid acceleration of its deployment strategy, especially infrastructure, the UK government risk losing CCS markets to European nations

The report addresses barriers to wider deployment of CCS projects in the UK, while also focusing on wider issues surrounding their financing, regulation and policy. It’s chaired by sector leaders Jon Gibbins, Professor of CCS at the University of Sheffield who has worked on energy engineering, fuel conversion and CCS for 45 years, and Niall Mac Dowell, Professor in Energy Systems Engineering at Imperial College London. The report is authored by Francesco Tamilia, Senior Policy Analyst for PPP. 

The technologies used to capture, use or permanently store carbon dioxide (CO2) resulting from human activity are collectively known as carbon capture, utilisation and storage, or CCUS. Leading climate and energy bodies such as the International Energy Agency (IEA), Intergovernmental Panel on Climate Change (IPCC) and the UK’s Climate Change Committee (CCC) have all outlined the crucial importance of these technologies in achieving net zero transitions.  

CCS technologies play unique roles in achieving decarbonisation in hard-to-abate industries such as cement, steel and chemicals. They are also needed to deliver carbon dioxide removals from the atmosphere with permanent geological storage, both to offer a route for all current emitters to atmosphere to achieve net zero by recapturing their CO2 and, very likely, in the longer term, to deliver an extended period of net-negative global emissions to reduce atmospheric CO2 concentration to a sustainable level. 

The UK government has committed to capturing 47Mt of CO2 by 2050, requiring a major upscale of current carbon capture operations. Thus, there is the need for a robust deployment plan to encourage adoption of CCS.  

The report has also found that private investment is pivotal in scaling up CCS infrastructure, but the government’s role should not be diminished. It must optimally use its policy toolbox to build strong revenue support frameworks for CCS projects and the utilisation of debt markets, thereby de-risking the costs entailed in developing CCS technology. 

The report, entitled Carbon capture and storage in the UK: Infrastructure to unlock investment, was developed in partnership with Third Way, a US-based think tank, and draws on a series of features, case studies, webinars, interviews and roundtables carried out throughout 2022. Throughout the report’s development, PPP has consulted cross-sector stakeholders in the UK from private and public sectors, as well as senior leaders in several countries including Brad Crabtree, Assistant Secretary for the Office of Fossil Energy and Carbon Management at the United States Department of Energy (DOE) and the Climate attaché to the EU Delegation to the UK, Emilien Gasc. 

Jon Gibbins and Niall Mac Dowell, Co-Chairs of the report said: The UK alone cannot avoid dangerous climate change by cutting its emissions to net zero, or beyond. However, by taking the opportunity now on offer to actually ‘put steel in the ground’ for CCS projects, we cannot only enhance current and future UK employment prospects and underpin future energy diversity, and hence energy security, but we can also make very material contributions to leading the future global market in CCS and CDR with permanent storage, that is essential to underpin successful global action.” 

Rt Hon Chris Skidmore MP, Chair of Environment APPG said:  “In order to achieve net zero carbon dioxide emissions by 2050, it is clear that carbon capture and storage will come to play a pivotal role. Beyond 2050, to keep global temperature rises at a minimum, we will also need a significant expansion in both CCS and direct air capture (DAC) technologies. Both the UNCCC and the IEA have been clear that while our focus to achieve net zero must depend on the wider deployment of renewable power, we need to continue to expand and invest in future technologies that can aid up to 50 per cent of future emissions reductions. This means making strategic long-term investment decisions in carbon capture and storage. The UK has been a global leader with its net zero industrial hubs, however the rest of the world is rapidly catching up, especially with the US Inflation Reduction Act that has prioritised investment in CCS and DAC.  

 “This PPP report, which is the result of a commission of leading authorities in the CCS industry, provides important insight into how future investment into carbon management might progress to provide certainty for the future deployment of carbon capture and storage” 

Ruth Herbert, CEO of the Carbon Capture & Storage Association (CCSA) said:  I am pleased to see that PPP has recognised in their report that CCUS is an integral part of reaching net zero and that the government must act now to deliver on its vital infrastructure developments. We are on the cusp of seeing the UK emerge as a world leader in CCUS, however this will only happen with collaboration and support from Government.”

Download a copy of the report here, for further information about PPP’s net zero policy programme please contact francesco.tamilia@publicpolicyprojects.com.  


Recommendations:  

1. Deliver on immediate plans for CCS, especially infrastructure

The government must deliver on its plans to support CO2 pipeline transportation and offshore geological storage infrastructure development for the three Track 1 CCS clusters, HyNet, East Coast and follow on infrastructure such as the Scottish Cluster (which is also the Track 1 reserve cluster) and Humber Zero. This infrastructure is the key physical enabler for industry to progress the initial deployment of CO2 capture projects and limited time is available to take UK CCS capacity from nothing to somewhere in the order of 100 MtCO2/yr by 2050. 

The government must also see through, to a successful conclusion, the undertakings made on funding support for CCS infrastructure, and the extensive work on business models for the different types of CO2 capture. Unless a reasonable return can be expected on investments, industry cannot be expected to commit to the construction and long-term operation of these facilities. These support measures are essential for the ‘first-of-a-kind’ projects now being contemplated; in the longer-term, other mechanisms, such a ‘carbon takeback obligation’ on fossil producers, may come into play. 

To justify government support, CCS projects should be rigorously tested against credible counterfactuals to ensure technical viability, value for money, affordability, contribution to security of supply and compliance with UK carbon budgets and nationally determined contributions. Investment should be targeted to support the preservation and creation of jobs, and to enhance productivity nationwide. 

2. Develop engineered carbon dioxide removals to put the ‘net’ into net zero

The government must ensure that CO2 removal from the air and permanent storage is also developed, taking advantage of the shared cluster infrastructure. While this will have higher costs than direct CO2 capture and storage from point sources it is an essential technology for putting the ‘net’ into ‘net zero’. In particular, because of the shared infrastructure and technologies, engineered CDR technologies such as bioenergy with carbon capture and storage (BECCS) and direct air capture with carbon storage (DACCS) should be treated as an integral part of CCS activities in government administration and policy making rather than being grouped with nature-based offsets and removals. 

 3. Build a world-class UK supply chain with sustained future deployment

If the UK is to develop a successful domestic CCS supply chain that can subsequently compete globally, clear government policy and signalling is required, particularly around support for future deployment on transport and storage, including shipping, and further CO2 capture projects. This will ensure that indigenous manufacturing capacity is developed, and that design and construction teams can be retained intact between projects. Finally, recent threats to the UK’s energy security have made domestic fossil fuel production a much higher priority. However, without full CCS with all the CO2 permanently stored, including carbon dioxide removal from the air as necessary, to give net zero GHG emissions, continued fossil fuel use, or methane production and conversion to hydrogen, cannot be consistent with the UK’s 2050 net zero target. 

 

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Health and Care Select Committee accepts PPP report as evidence in integrated care inquiry  

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ICS Futures, Public Policy Projects

The Heath and Care Select Committee has accepted a recent report from Public Policy Projects as evidence in its inquiry to consider how Integrated Care Systems (ICSs) will deliver joined up health and care services to meet the needs of local populations.


The inquiry considers how ICSs will be able to operate with the flexibility and autonomy required in order to tackle inequalities in the populations they serve and whether the pursuit of central targets can be consistent with local autonomy. 

PPP’s report, ICS Futures, examines the decision-making processes of ICSs and how they choose to adapt their services to meet local population needs. The report collates the key findings from three roundtables, each chaired by Matthew Swindells, former Deputy CEO of NHS England current Chair of the North West London NHS Acute Collaborative. Each roundtable convened up to 30 ICS Chairs and key transformation stakeholders. 

The report presents a series of recommendations to both national government and ICS system level leadership across three core topics:  

  • Digital Infrastructure and Health Data 
  • The Development of Primary and Community Health Serivces and Links with Social care
  • Prevention, Early Intervention and Health Inequalities

Ensuring all parts of the sector get a seat at the table

ICS Futures tackles with profound questions relating to system vs place-based decision making, dissecting key issues relating to governance and accountability. The report insists that ICSs should come to represent a ‘partnership of equals’ between different parts of the system, particularly social care.

PPP’s report also found that historic tensions between the subsidiarity of place with aggregation and scale remain prominent across England’s health and care system. ICSs will need to grapple with these challenges in a way that works best for their localities, adopting flexible approaches that allow for system wide direction while not stifling local innovation. 

There remains a lack of awareness among the public, and indeed within the health service, of the full range of care provision available within a locality, whether that be social care, secondary care, primary care, social prescription, or tertiary care. 

The expertise and insight of the social care sector remains an underused resource in driving system transformation and understanding and awareness of social care provision across within ICSs remains low.


Data sharing as a duty of care 

Among the key data findings from ICS Futures is the fact that ICSs are currently grappling with a heavily fragmented data platform landscape, with many competing systems in use. This ‘platform soup’ mentality lacks the cohesion necessary for ICSs to implement population health management approaches. There are many legacy systems, often used previously by individual CCGs, that do not necessarily interoperate with system wide solutions. 

The report recommends that ICBs be empowered to make bold decisions, potentially scrapping old legacy data systems in favour of system-wide interoperability.  

The report does however find that ICSs have made a good start in developing data strategies by creating data analytics teams across the country and that the crisis of Covid-19 has shifted the dial in favour of greater interoperability and data sharing – this is further emphasised by the Inegrated Care Partnership onus on collaboration above competition.

Despite recent progress, the report finds that there remains significant apprehension to data sharing, both among the public and the health and care workforce. Much of this relates to previous lapses in data security (or at least the communications strategies that surrounded them), but also a fear that data will be used for performance management purposes. 

In order to firmly establish the importance of data, ICS Futures recommends that the NHS constitution should be amended to establish data sharing as a duty of care. ICS leadership should work to embed this mentality, both for clinicians using the data, and for the patients and end users on the receiving end of its benefits. 


Health inequality as a tangible objective 

The ICS Network agrees that tackling health inequality must be the central objective of integrated care, and this should be considered a unifying objective across health and care providers. However, there are tensions between aspiration and reality within health inequalities; there is a sense that reporting structures around health inequality have been taken to system level when the truly valuable data can be measured and harnessed at place level. 

Crucial to this discussion is differentiating between determining factors associated with long-term economic inequality and social deprivation against factors well within NHS control, such as inequalities within waiting lists.  ICS Futures asserts that the NHS has yet to fully utilise its potential as an anchor institution. 

In addressing health inequalities, it is vital that ICSs become a coordination point for broad public service integration and not simply a machinery to break down siloes within the NHS. ICBs should look to leverage their position as conveners of key public sector organisations and push for policies that promote economic regeneration and help target deprived and disenfranchised communities. This could include initiatives to push health providers to make prioritised recruitment drives from more deprived areas within their systems, and an onus to not outsource public sector contracts that could hold employment opportunities for local communities. 


For this wave of reform to be successful, ICSs will need to break with historical mistakes, focusing on outcomes over outputs, relationships over structures and above all else, people

Commenting on the launch of the report and its acceptance into the Health and Care Select Committee’s inquiry, David Duffy, Head of Content at Public Policy Projects and co-author of the report alog side PPP Content Editor Gabriel Blaazer said: “Integrated care is not a new concept, and ICSs do not represent the first attempt to join up health and care services. For this wave of reform to be successful, ICSs will need to break with historical mistakes, focusing on outcomes over outputs, relationships over structures and above all else, people. 

“Previous iterations of integrated care have failed to effect significant change because decision makers have not had the tools they needed to drive service reform, or were simply not aware of what was available to them. This lack of awareness is still present within current ICSs structures, partly due to ongoing tensions between aggregation and scale against place-based decision making. 

“We are pleased that our report has been accepted as evidence in the Health and Care select Committee’s latest Inquiry, and we hope to continue to submit further evidence as we travel the country in our ICS Roadshow series, where we are evaluating the progress of integrated care at a localised level.” 

Download the full version of the report here. Alternatively, an executive summary version is now available on the Health and Care Select Committee’s website labelled with reference: ICS0045. 

Across the autumn, PPP will be taking the findings of this report and applying them at a local level. The ICS Roadshow is a series of half day conferences that convenes local stakeholders and system leaders across five different regions across the autumn. 

Government is falling short on its commitments to the rare disease community – new report

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Rare disease community

A new report from Public Policy Projects (PPP) has found that standards of care for those living with rare diseases in the UK fall below government commitments set out in its England Rare Diseases Action Plan 2022.


  • New report calls for the government to do more to rebalance equity of care for the rare disease community  
  • The UK currently falls outside of the top 20 European countries by number of conditions for which it screens, with the heel prick test only screening for nine conditions  
  • Report is the culmination of over 10 hours of discussion between February and May 2022, among more than 60 participants, and case study submissions  

A new report from Public Policy Projects (PPP) has found that standards of care for those living with rare diseases in the UK fall below government commitments set out in its England Rare Diseases Action Plan 2022. The report also finds that, despite recent progress in developing rare disease frameworks and Action Plans, the UK is falling behind other comparable countries in the diagnosis and treatment of rare diseases.   

The report, A Fairer Future, does acknowledge recent government commitment to deepen understanding of specific conditions and increase the development of treatment and drugs. These commitments include increased funding into Genomics England’s Newborn Genomes Programme and the creation of the NHS Genomics Service.  

A Fairer Future also calls for greater attention to be given to rare diseases with non-genetic causes. While recent funding increases for genomics research is welcome, a too narrow focus on genetically caused rare disease will fail to address wider population needs on rare diseases, resulting in a standard of care below government ambitions.  

The report argues that policy must reflect the needs of all those who live with rare diseases and conditions, noting that the size of the UK’s rare disease community would collectively amount to the second most populous city in the UK. Also among the report’s recommendations are calls to widen the availability of Whole Genome Sequencing, to expand the number of conditions which are screened for, and to increase awareness among the healthcare workforce and public of the Genomic Medicine Service.   

Recommendations include:   

  1. As the Genomic Medicine Service is rolled out it is essential that healthcare professionals, including the anti-natal and neo-natal workforce, be informed on the impact this may have on newborn babies and those exhibiting symptoms. This is to ensure expecting mothers and new parents, are provided with appropriate time to familiarise themselves with the service and potential options available to them.   
  2. The list of conditions currently screened for, using the heel-prick test, should be expanded by the National Screening Committee to include those such as Spinal Muscular Atrophy (SMA) Type 1, for which a gene therapy exists. This should occur in addition to the ongoing Newborn Screening Programme. It should be a commitment that this aim be met before the completion of the Newborn Screening Programme, run by Genomics England (GEL), in 2025.   
  3. Whole Genome Sequencing (WGS) in newborns may result in a potential 3000 more patients entering the healthcare system every year. It is essential that in ongoing consultations the system be prepared to absorb those diagnosed. The implications upon clinical services to respond and develop timely care plans must be considered, to ensure newly diagnosed patients and families to not end up on disproportionally long waiting lists.  
  4. To harness widespread engagement and raise awareness of rare diseases beyond the healthcare ecosystem, the conversation must be rephrased. A collaborative and cross-sectoral recasting of public perception and understanding through the lens of ‘population health impact and intervention’, should work towards harnessing an understanding of the health impacts of rare diseases beyond those directly affected.  
  5. Universities, Royal Colleges, Health Education England, and other professional bodies and academic institutions should promote the upskilling and further education of their students and healthcare professionals. It is also essential that these be completed by key decisionmakers within the health service, for example those allocating resource for commissioning services, to ensure impact is felt across the health ecosystem. These may be delivered through virtual and in-person workshops.  
  6. Living with a rare disease places substantial strain on mental health. In anticipation of the reforming of the Mental Health Act, a focus on effectively integrating mental health services and support into rare disease services is essential. Not only for the individual living with the rare disease or condition, but for their family and carers as well.  
  7. Whole Genome Sequencing (WGS) in newborns may result in a potential 3000 more patients entering the healthcare system every year. It is essential that in ongoing consultations the system be prepared to absorb those diagnosed. The implications upon clinical services to respond and develop timely care plans must be considered, to ensure newly diagnosed patients and families to not end up on disproportionally long waiting lists.  
  8. Universities, Royal Colleges, Health Education England, and other professional bodies and academic institutions should promote the upskilling and further education of their students and healthcare professionals. It is also essential that these be completed by key decisionmakers within the health service, for example those allocating resource for commissioning services, to ensure impact is felt across the health ecosystem. These may be delivered through virtual and in-person workshops.  
  9. Living with a rare disease places substantial strain on mental health. In anticipation of the reforming of the Mental Health Act, a focus on effectively integrating mental health services and support into rare disease services is essential. Not only for the individual living with the rare disease or condition, but for their family and carers as well.  

   

Dr Shehla Mohammed, Consultant and Paediatric Clinical Geneticist, Guy’s and St Thomas’ NHS Foundation Trust, and Project Co-Chair said: “It has been a privilege to work with and learn from so many colleagues across so many disciplines over the past six months. We thank them for their enthusiastic participation and for their wise and insightful contributions. The report is a unique endeavour to articulate the key role of the patient voice in Rare Diseases. It offers a set of pragmatic and realistic recommendations which come from patients and those caring for them to ensure sharing knowledge and good practice can provide equitable access to diagnosis, management and treatment. We are optimistic that this will enable realisation of the key priorities of the UK Rare Diseases Framework which can meet the needs of those with living with rare diseases and for their families.”   

Alastair Kent OBE, Independent Patient Advocate, and Project Co-Chair said: “Recent scientific progress in our understanding of rare diseases at the molecular level has been unprecedented. Listening to the experiences of patients and families affected by these conditions has been essential., enabling new knowledge to be translated into innovative therapies and improved services and support. Putting patients and families at the heart of this process values their expertise and experience and helps speed progress.  The production of this PPP report has been led by the views of patients and families from the outset, ensuring it is realistic, relevant and robust in the conclusions it draws and the recommendations it puts forward.”   

Daniel Lewi, Business Development – Rare Disease, Cognitant; and, Co-Founder and Chief Executive, CATS Foundation said: “The report has highlighted the fact that education about rare disease should not only focus on the patient and their family, but also include health care professionals. We need to start this process collectively so that we can empower patients to take control of their own health which will ultimately enable them to become their own advocate.”   

Press release

New report calls for country to embrace collaborative primary care at scale

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primary scale at scale

A new report from Public Policy Projects (PPP) and Healthworks has called for the wholesale scaling of the provision of primary care in the UK to drastically improve patient outcomes and system efficiency.


  • The primary care sector should embrace and indeed “celebrate” the mixed economy of health and care
  • Each of the four contractor services of primary care, and their respective local commissioners, must improve understanding of what each other service does
  • Pharmacy sector must be open to a radical change of structure and mindset in order to maximise its huge potential for facilitating integrated care 
  • Local commissioners must generate greater clinical collaboration with the optometry sector, ensuring it becomes a key component of diagnostic and preventative care
  • ‘Build back better’ should be used to increase preventative and restorative dental care; dental contracts must be reformed to help further integrated with PCNs and address chronic unmet need for dental care

The report: Stronger Together: Collaborative Primary Care at Scale, relates to the four contractor services that make up primary care: general practice, community pharmacy, dentistry and optometry. The report advocates a move away from a contractual process-dominated approach to primary care to one defined by quality improvement metrics and population health.

The report also calls for the acknowledgement of the mixed nature of the country’s health economy. Three of the four primary care services, pharmacy, dentistry and optometry, rely heavily on their continued existence on non-NHS contract funding. Indeed, the gap between NHS funding and private-pay work is widening. However, there remains significant distrust and misunderstanding of “profit-driven” healthcare across the public and even amongst the healthcare profession.  

The report calls for the adoption of ‘Primary Care at Scale’ (PCaS), the purpose of which is to extend the provision of health and care services within a community setting through an integrated, team-based approach.  

The report is made up of contributions from thought leaders within the health and care sectors and representatives of the wider communities of primary care providers and professions.  

Professor James Kingsland OBE, Chair of the report, said: “It is relatively uncommon for the collective views of general practice, community pharmacy, dentistry and the optical sector to be expressed in one publication. Stronger Together tackles historically siloed approaches to addressing and reforming primary care, highlighting challenges that are both unique to each contractor service and those that are shared across the sector.” 

Michael Lennox, Member of the National Pharmacy Association and contributor to the report, said: “Primary care at scale is not just possible, but a necessary progression for the sector. We are seeing a reboot of belief for what community pharmacy can bring to the table. 

“In many ways, community pharmacy is already being delivered at scale, with over 10,000 pharmacies across the country – equating to 2 per GP practice. These services are here and they will continue to grow. The main barrier to this collaboration is people – do we trust each other? Do we have the right technology platforms to facilitate cross-discipline working? The Stronger Together report highlights the enormous benefits of generating true collaboration across each of the disciplines of primary care” 

Zoe Richmond, Clinical Director, Local Optometry Support Unit and report contributor, said: “The report highlights that we all have a duty to better understand what each of the four contractor services of primary care do. There is so much to be gained from this enhanced understanding and collaboration.  

“We need to encourage significant behaviour changes if we are to truly optimise primary care. Data sharing and increased digital connectivity has been long overdue for optometry.” 

Professor Paul Batchelor, said “Workforce problems are evident across all primary care contracting groups. What has happened in dentistry is a move away from simply NHS arrangements and the contract for which current NHS dentistry is provided is simply not fit for purpose.  

“If we are to have truly integrated care, then the dentistry sector will need to work much closer with the other contractor services that make up primary care, the sector must adopt at at-scale approach to delivery that is defined with the Stronger Together report.” 

Also commenting on the report, Dr Farzana Hussain said: “Integrating care must start focusing on integrating services, not systems, ensuring that care pathways are integrated. Changing behaviours is more than simply addressing contractual changes in the sector.   

PCNs need to rise above contractual requirements, they need to be about delivery and integrated health. We need to live these aims, not just talk about them.   

“I am very much somebody who believes care should be absolutely free at the point of need. For the first time, I am seeing my patients going towards private providers. Tt might not be sinful to think about increased private funding…if we do not think about this about that then I fear we will lose lives.”  

Read and download the report here.

Key recommendations

The authors’ recommendations are that the four primary care contractors and their commissioners should: 

  • Seek to develop a culture in which co-production of care between four primary care contractors is paramount, working towards helping ensure each sector knows and understands how best it can work to support improved outcomes for patients.
  • Confront the challenges of addressing inequalities through the adoption of population health principles and techniques.
  • Acknowledge that the mixed economy supports the NHS.
  • Adopt a more meaningful mantra than “building back better” – perhaps “achieving fair and sustainable health improvements”.
  • Note the importance of the principle of national consistency in design and delivery of some services, but also that contractors and commissioners work to “acceptable variability”, tailored at local level.

The full recording of the Stronger Together launch event can be viewed below.

 

About Public Policy Projects 

Public Policy Projects is a global, liberal public policy institute. The institute is independent and cross-party, bringing together public and private sector leaders, investors, policymakers and commentators with a common interest in turning public policy into actionable insights. Public Policy Projects does not advocate on behalf of any organisation. 

About Healthworks 

Healthworks works closely with health and care systems to improve effectiveness and efficiency for the benefit of populations. It creates pragmatic and sustainable solutions that address the most challenging problems within the NHS and social care. 

Its thinking is shaped by its people who have unparalleled experience and have walked the NHS and social care walk over many years. Its core purpose is to design, develop and deliver ideas that work. 

It is pre-emptive in its thinking and approach, in the development of powerful ideas that bodies across health and social care are actively investing in. 

In short, Healthworks is about: 

  • Truly innovative ideas 
  • Ideas that are experiential and evidence-based 
  • Ideas that will actively transform 

Media enquires 

For further information, or to request interviews, please contact:  

Press release

New report: The climate crisis and its health impacts

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the climate crisis and its health impacts report cover

World Health Organization (WHO) should declare climate change a public health emergency, says new report by Public Policy Projects, chaired by Seb Dance.


  • WHO should consider revising the narrow disease-specific definition of public health emergency of international concern (PHEIC) to include climate change 
  • UNFCCC’s National Adaptation Plans (NAP) should give a greater focus to health and support national governments with the development of their climate- and health-related plans 
  • Medical schools should include climate change and its corresponding health impacts in the medical curricula

A new report by Public Policy Projects (PPP) has called the World Health Organization (WHO) to declare climate change a public health emergency of international concern (PHEIC). The report, chaired by former Deputy Chair of PPP’s Environment Pillar and currently Deputy Mayor of London Seb Dance and authored by PPP Policy Analyst Francesco Tamilia, showcases the devastating impacts of climate change on people’s health.

According to the WHO, climate change is the single greatest threat to global health in the 21st century. Ahead of COP26, more than 45 million health workers from across the world wrote an open letter to world leaders calling for urgent climate action to protect people’s health. Over 200 health journals worldwide have also urged world leaders to take action to keep global temperature increases below 1.5C and protect health. Climate change also threatens to reverse many of the advances in global health over the past 50 years and further widen existing health inequalities.

The Office for National Statistics (ONS) has also stated that: “Climate change is the greatest long-term health threat globally and is expected to impact the UK increasingly over the coming years. We need to monitor and report those effects to inform the public and policymakers.”

Although the health impacts of climate change are already unfolding across every continent and are causing thousands of deaths every year. PPP’s report, The climate crisis and its health impacts, argues that the relationship between climate change and health is still widely underappreciated by policymakers and the public.

The PPP report also calls for national governments to develop effective strategies, as part of UNFCCC’s National Adaptation Plans (NAP), to identify, address and review the health impacts of climate change in their countries. NAPs should also place a greater focus on health and support national governments with the development of their climate- and health-related plans.

The report not only highlights the intimate link between climate change and human health but also illustrates the actions that can be taken to remedy this health crisis. The Climate Crisis and its Health Impacts outlines a series of solutions that governments and policymakers can implement to mitigate the health consequences of climate change.

Commenting on the report:

Seb Dance, Chair of the report, said: “Every day we take action to mitigate damage to ourselves. We avoid certain foods and limit our intake of harmful substances. We exercise and quit smoking and subscribe to gyms and nutritional programmes where we can to help guide us down a healthier path. But none of us can avoid climate change, much less those with the fewest resources for whom, as with every public health crisis, the options to mitigate are not always readily available. It is time to put a health warning on the biggest global challenge we face: climate change kills.”

Rt Hon Chris Skidmore MP, former Minister of State for Energy and Research Director at PPP said: “National governments must deal with the climate crisis with the same urgency and effectiveness seen during the Covid-19 pandemic. Proactive and effective actions must become the ordinary ones when tackling climate change. By taking actions on climate, such as switching to clean energy, we are also protecting people’s health. Climate change and health are two sides of the same coin.”

Elaine Mulcahy, Director, UK Health Alliance on Climate Change said: “The recent IPCC report warned of the grave threat of climate change to human wellbeing and planetary health. Already, many of the health impacts of climate change are being felt causing thousands of deaths every year with overlapping challenges of increased exposure to heatwaves and heat-related mortality, increased risk of food, water and vector borne diseases, increased mental health challenges, and the devastating consequences of air pollution. We need to move quickly to address these challenges to protect health, while also realising the significant potential health benefits that can be achieved through the actions we take.”

View and download the report here.

Key insights of the report:  

  • WHO should consider revising the narrow disease-specific definition of public health emergency of international concern (PHEIC) to include climate change.
  • National governments should develop effective strategies to identify, address and review the health impacts of climate change in their countries. National Adaptation Plans (NAP) should give a greater focus to health and support national governments with the development of their climate- and health-related plans.
  • Medical schools should include climate change and its corresponding health impacts in the medical curricula. Health professionals including doctors, nurses and midwives should undertake, as part of their studies, modules that explain the various links between climate change and health and its health consequences.
  • Increase the public and policymakers’ understanding of the multiple public health benefits of switching to clean energy, and how this will subsequently improve air quality and ultimately improve health outcomes. Such benefits should be amplified within governments’ strategies on climate change mitigation and adaptation.
  • Governments should carry out cross-sector awareness campaigns on the impacts of the heatwave on human health, targeting policymakers, health professionals and the public. These campaigns should include relevant information depending on the audience.Health professionals need more comprehensive training to help identify heat-related conditions.The public needs to know what steps and measures they can take ahead of a heatwave, so they can better protect themselves during the heatwaves.
  • Policymakers must recognise the urgency of this issue and work towards effective policy changes such as introducing strong early-system warnings. This should include a naming system for heatwaves similar to storms, to raise public awareness of this ‘silent killer’.
  • Public health communities should be incentivised to undergo training in infectious diseases. They should reduce the knowledge gap and promptly identify infectious disease cases and treat them accordingly. As first responders, this is particularly important for those health professionals in geographical areas where experts have predicted an increase in environmental suitability for certain infectious diseases
  • Early-warning systems have proved critical in tackling climate-sensitive infectious diseases. Governments should invest in these technologies and establish support groups that seek to identify emerging diseases.
  • Emerging new studies are drawing a worrying picture on how climate change is impacting people’s mental health. Governments should conduct an in-depth study to reveal the full extent of the problem.
  • Governments should investigate whether health professionals, in particular psychologists and psychotherapists, have the expertise and the means to deal with something on the scale of the climate crisis. Potential future training and continuing professional development will be required within the healthcare system to prepare for climate-related exacerbation of mental health conditions.

To access the video recording of the webinar report launch, click here.

About Public Policy Projects 

Public Policy Projects (PPP) is a global policy institute offering practical analysis and development across sectors, including net-zero and climate change. The institute is independent and cross-party, bringing together public and private sector leaders, investors, policymakers and commentators with a common interest in turning public policy into actionable insights. Public Policy Projects does not advocate on behalf of any organisation.

Media Enquires

For further information, or to request interviews, please contact:  Francesco Tamilia, Policy Analyst and author of the report, Public Policy Projects, francesco.tamilia@publicpolicyprojects.com

Press release

New report: How to re-engage patients with cancer pathways

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Long-term funding plan for workforce and capital investment needed to rapidly scale-up cancer services in response to “calamitous” pandemic impact.


  • Cancer services must be rapidly scaled-up top meet post-Covid surges in referral rates
  • Strategies to transform diagnostic services proposed by Professor Sir Mike Richards must be implemented without delay, with a detailed delivery plan that includes capital investment and workforce funding
  • “Unacceptable” variations in regional performance must be addressed through targeted actions to address inequalities in cancer services currently described as a “postcode lottery”

A new report from Public Policy Projects (PPP) has called upon government and health providers to drastically scale-up and improve cancer services across England. The report comes in response to what it describes as a “calamitous” impact upon UK cancer treatment in the wake of Covid-19.

How to re-engage patients with cancer pathways

The report: How to re-engage patients with cancer pathways

How to re-engage patients with cancer pathways, published on Thursday 27 May in partnership with MSD, outlines a series of recommendations to not only improve oncology services in response to the pandemic, but to address longstanding issues, such as poor waiting times and sub-standard survival rates by international standards.

With cancer rates rising in line with the UK’s ageing population, demand for oncology services is only set to increase in future. The report states that NHS England’s “fine ambition” of diagnosing 75 per cent of cancers by 2028 is not on track to be delivered, with early diagnosis hovering at around 55 per cent for several years.

The reasons for this lack of progress are plentiful. The UK is currently “severely compromised” by a chronic shortage of diagnostic capacity, with much of the current equipment being obsolete. Further, the workforce must be significantly expanded and reshaped to meet current and future demand – the NHS still lacks a robust plan to meet current and future workforce requirements and the government has yet to commit the funds to deliver one.

The report also finds stark variations in regional performance across the country and describes the state of UK cancer care as a “postcode lottery.” Analysis of 2017/18 data by the National Audit Office of the percentage of patients treated within 62 days of a GP referral revealed that the performance of clinical commissioning groups varied from 59 per cent to 93 per cent, against a standard of 85 per cent. The report strongly recommends that integrated care systems (ICSs) be given greater responsibility for cancer services in their area.

The report hails the work of Professor Sir Mike Richards, particularly around his emphasis on moving diagnostic capacity into the community. To this end, PPP recommends the swift implementation of all of Professor Richards recommendations in his recent report.

Pandemic disruption has had a devastating impact upon already stretched cancer services across the UK. Lung cancer screenings effectively came to a halt, urgent referrals in primary care collapsed and, while there has been a significant recovery in urgent referrals, the drop-in service means that 350,000 fewer people have been referred urgently across the UK since the beginning of the pandemic compared with a normal year.

A key recommendation of the report is to ensure the NHS takes steps to restore public confidence on the safety of cancer services by publishing steps to ensure they are Covid-free. Concerns about catching Covid became intertwined with pressure to “protect the NHS” and fear of contracting Covid led many patients to postpone seeking help or to miss appointments. This issue was compounded a lack of trust in Government information, where mixed messages only served to add to the confusion.

In addition to diagnosis, cancer treatment has also been severely disrupted, with delays to surgery exacerbating the problems of late referral and diagnosis – as patients are presenting themselves with more advanced stages of cancer. The pandemic has also led to skyrocketing diagnostic wating times, domestic tests for suspected cancer were 10 times the length in August 2019. The plunge in diagnostic activity has also led to “some cancers progressing to a stage where they were no longer treatable,” the report says.

Marginal gains will not be enough to restore services to pre-pandemic level, the report says that “the aim must be to finally deliver world-class cancer care through service transformation”.

Among a host of key recommendations, the report calls for strengthening of the relationship with key cancer charities, many of which have suffered from heavy funding cuts over the past year, a close examination as to the benefits of remote cancer care, the immediate reopening of cancer treatment trials to deliver potentially lifesaving treatments to patients, and recommends that real-time data be harnessed to revolutionise service.

Commenting on the release of the report, Professor Sir Mike Richards said: “The Covid-19 pandemic has shone a major spotlight on cancer services both highlighting weaknesses in current service provision and demonstrating opportunities for improvement. The PPP report has identified 16 recommendations. It is now vital that we take these forward in order to bring cancer survival in this country up to the best in the world.”

Baroness Nicola Blackwood, Deputy Chair of Healthcare and Life Sciences at PPP, said: “The calamitous impact of the Covid-19 pandemic on UK cancer treatment has again highlighted the urgent need for an overhaul of every aspect of our cancer services. However, these profound impacts are as much a symptom of the underlying weaknesses of cancer care as a measure of the severity of the pandemic.

“We have known for years that our diagnostic equipment is scarce and obsolete, that the cancer workforce is too small to meet even current, let alone future, demand, that there are too few intensive care beds and that people are dying because treatment comes too late.”

David Long, Business Unit Director, Oncology, MSD, said: “The way that the health community has come together to combat the Covid-19 pandemic is tremendous. This was particularly demonstrated in cancer services through efforts to keep patient pathways open and flexible to the evolving situation. It continues to be demonstrated as everyone pulls together to recover those cancer services.

However, it is well recognised that the system was by no means perfect for clinicians or cancer patients before the pandemic. That is why we welcome the opportunity to support this initiative to examine the opportunities to come back from the pandemic with a system that is better than the one that went before it – and to continue the spirit of collaboration that has achieved such significant change in such a short period of time.”

View and download the report here.

Notes to editors

Recovery and transformation

The report makes several recommendations to restore and indeed improve UK cancer services:

  1. A long-term funding plan for capital investment and workforce for next CSR to facilitate major scale up of UK cancer service capacity.
  2. Strategy to transform diagnostic services proposed by Professor Sir Mike Richards must be implemented as quickly as possible.
  3. Unacceptable variations ion regional performance must be addressed through targeted measures and ICSs need clear responsibility for driving service improvements.
  4. Cancer services must be delivered at Covid safe hubs and public confidence should be restored in cancer service safety.
  5. The NHS needs to routinely collect cancer data based on deprivation and ethnicity.
  6. Care for people with incurable cancer must be improved.
  7. Cancer screening must be restored and expanded.
  8. Involvement of cancer charities must be maintained and strengthened.
  9. New pathways adopted during the pandemic should be adopted permanently where appropriate.
  10. Benefits of remote cancer services must be evaluated.
  11. The NHS must increase capacity for harnessing real-time data on cancer, so that data can be acted upon promptly.
  12. Cancer treatment trials must be fully reopening and expanded.
Press release

New report: Practical care for effective integrated care systems

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The Health and Care Bill must clarify its position on the statutory basis of the ICS Health and Care Partnership Board.


  • Joint working between the NHS and local government must reflect a genuine partnership of equals.
  • Those working in the social care sector need to be awarded with status and pay to match that of their NHS colleagues.
  • Report launched by Rt Hon Stephen Dorrell, former Secretary of State for Health, Phil Hope, former Minister of State for Care Services and other senior thought leaders including Patricia Hewitt, Independent Chair of Norfolk and Waveney ICS

 

As Parliament debates the Health and Care Bill, a new report from Public Policy Projects (PPP) has called upon Government to place the voice of local government and social care on an equal footing to the NHS. The report comes in response to the Government’s Integration and Innovation white paper and sets out a blueprint for how integrated care reform can be delivered in practice.

Effective integrated care systems

Practical action for effective integrated care systems, published on 13th July in partnership with DevoConnect, outlines a series of recommendations to achieve parity between local government and the NHS and address social care with the same vigour as acute care.

The report, co-chaired by Rt Hon Stephen Dorrell, former Secretary of State for Health and Phil Hope, former Minister of State for Care Services, consulted with a range of key stakeholders in Integrated Care Systems (ICSs), local government, public services and across political parties. Two key findings emerged from these evidence sessions: the white paper does not sufficiently prioritise the local government voice and fails to achieve parity of esteem between the NHS and social care.

The report welcomes the commitment of NHS leadership to ensure that NHS services are joined up with other local services. However, there are strong cultural and institutional constraints to this potentially transformational development, the report warns, which needs to be addressed in a sustain way.

It is regretteble that the current draft of the legislation does not provide a statutory basis for the ICS Partnership Board. The former Secretary of State for Health stated that his objective was to strengthen national political control of NHS services. The report recommends that his successor amends the health and care bill to provide a statutory basis for the Health and Care Partnership Board and a statutory framework for partnership budgets which addresses the priorities agreed by the Partnership Board.

The Covid-19 pandemic has raise dramatically the status and value of social care in the public eye. The report recommends that the bill is amended to provide a new framework for social care which includes a commitment to increase funding for social care and arrangements for a Social Care People Plan to match the NHS People Plan.

 

The report identifies a series of key recommendations:

  • The decisions of the ICS NHS Board should be compliant with the aims and priorities of the ICS partnership board. Further guidance should be produced on how the ICS NHS board should have due regard to the ICS health and care partnership board health and wellbeing plan, and there should be a statutory duty on the NHS and local government to collaborate.
  • The ICS partnership board should be placed on a statutory footing with a duty to plan and deliver a comprehensive health and wellbeing strategy, built on local place-based strategies, to improve population health and reduce health inequalities within its health geography.
  • Action by the Government to support parity of esteem between health and social care in general, and parity of earnings in particular, is essential for ICSs to plan and manage their ICS workforce based on the requirements of the local population’s health, social care and public health needs.
  • A key step towards integration of the planning and management of local health and social care workforces by ICSs is for the Government to publish a social care people plan that mirrors the NHS People Plan. A further step would be to merge these into a single health and social care people plan to underpin local plans developed by ICSs.

Phil Hope, co-chair of the PPP report, said: “The Health and Care Bill presented to Parliament for debate provides a unique opportunity to build back a fairer health and social care system after the pandemic. But the legislation must create a genuine partnership of equals between the NHS and Local Government to deliver better health and social care services, and reduce health inequalities within our communities.

Failure to do so could lead to a more centralised NHS focused yet again on acute care in hospitals rather than on building local integrated systems which provide better care closer to home and tackle the causes of ill-health in the population.

Our report makes 31 recommendations for developing effective integrated care systems concerning their governance, collaborative working between service providers, system performance and incentives, funding flows, the workforce, digital health and the public estate. Some of these concern changes to the Bill whilst others are suggestions for good practice that every integrated care system could consider in this vital year of their development.

And it will be essential that proposals to reform and fully fund our social care services are brought forward without delay. Those who need social care, and those who provide it, deserve a fair deal and parity of esteem with our health services if we are to create an integrated health and social care system we can all be proud of.”

Commenting on the release of the report, Naomi Eisenstadt, Independent Chair of Northamptonshire ICS said: “The Government’s plans for integrating health and social care are ambitious and should be welcomed. Achieving the core aims of improving health and reducing inequalities in health outcomes is challenging. Making progress will be much more likely if the recommendations in this report are implemented. I am convinced we can improve health by public bodies and the voluntary and independent sector all working together. This wise report should help us in that task.”

Patricia Hewitt, Independent Chair of Norfolk and Waveney ICS said: “With the NHS Bill published last week, this timely report will make a valuable contribution to the debate about how each ICS should take advantage of the great opportunities presented by becoming a statutory system from April 2022.”

Also commenting on the release of the report, Matthew Stickland, Director of Strategy and Communications at TPP said: “Integrated Care Systems have the ability to enable cross-organisation working and new forms of collaboration between the NHS, local governments, and the third sector. This report highlights a number of key practical considerations to help achieve genuinely integrated care across a region.

From a digital health perspective, the recommendations outline the importance of clear digital leadership on the ICS board. In my view, careful consideration is needed when it comes to ICS board representation, in order to move toward a collective responsibility for digital maturity across the whole system.

It is widely recognised that technology can play an important role in facilitating integrated care, providing a better experience for patients, improving outcomes, and supporting the workforce. We need digital systems that genuinely assist staff and facilitate high quality care across an entire ICS. These systems need to interoperate, so that vital data is always available at the point of care. They also need to support data flows for population health and for improved planning. Any systems deployed must be cost effective and leave enough room in the IT budget for investment in people. This is key to ensuring the success of ICSs.”

This programme of work has been written in partnership with DevoConnect. Sponsorship for this report has provided by TPP and Cerner. Public Policy Projects have retained full editorial control.

View and download the report here.