The Health and Care Act 2022 was given Royal Assent today and puts children at the heart of NHS integrated care. The Health and Care Act 2022 will change the way that services are planned and delivered by the NHS, local authorities, and other key organisations.

 

The iHV has been a member of the Health Policy Influencing Group (HPIG) which is hosted by the National Children’s Bureau (NCB) and the Council for Disabled Children (CDC). HPIG membership spans across 70 leading organisations who represent a strong, independent voluntary and community sector voice for babies, children, and young people (CYP) aged 0-25 years. After nearly a year of collaboration, determination and hard work, babies and CYP are now at the heart of the Health and Care Act reforms.

 

Members of Health Policy Influencing Group (HPIG)

Alison Morton, iHV Executive Director, said:

“Today’s Royal Assent of the Health and Care Act is a cause for celebration, representing a significant step towards improving health legislation for babies, children and young people. We were delighted to work with others as part of the Health Policy Influencing Group and support the drafting of the amendments to the Bill as it progressed through Parliament. This positive movement for change has been instrumental in bringing greater recognition of children’s needs (including babies) within the final Act. I would like to thank colleagues at the NCB who do a brilliant job leading the HPIG and all the members of the group that were instrumental in making these changes.”

The Act introduces two-part statutory Integrated Care Systems (ICSs), comprising an integrated care board (ICB), responsible for NHS strategic planning and allocation decisions, and an integrated care partnership (ICP), responsible for bringing together a wider set of system partners to develop a plan to address the broader health, public health, and social care needs of the local population.

The most significant change relates to the expectations of the 42 ICBs that are replacing Clinical Commissioning Groups (CCGs) across the country from 1 July. The Act sets out the steps it will take to address the needs of babies and CYP under the age of 25 in their five-year forward plans.

Further positive changes include:

  • New statutory guidance, which will be produced by NHS England, will require ICBs to nominate an executive children’s lead, responsible for ensuring the ICB sets out clearly the steps it will take to address the needs of babies and CYP.
  • NHS England issuing statutory guidance which will include a statement that each ICB must nominate an executive children’s lead, ensuring leadership for babies and CYP on every ICB.
  • ICBs reporting annually on how they are delivering their child safeguarding duties.
  • Steps to improve information sharing to better support children and keep them safe. The Government has acknowledged serious and distinct challenges around the sharing of timely and relevant information about children between agencies, particularly vulnerable children, and has committed to delivering change in this area. The Government will now lay a report before Parliament within a year, setting out:
    • A policy on a consistent identifier for children and its approach to improving information sharing more generally.
    • How this can be achieved across health, children’s social care, police, and education settings.
    • Cross-government actions that will be taken to implement the policy set out in the report.

Much more work is needed in this area and HPIG plans to support the implementation of this, alongside more detailed policy development. However, the Act represents a fantastic achievement, ensuring that babies and CYP are at the heart of integrated care, and this is something which needs to be celebrated!

The iHV would like to express a heartfelt thank you to the NCB and CDC for leading this important work. We are proud to be members of the HPIG and look forward to continuing our work as part of this group, providing a united voice for babies and CYP, now and in the future!

The Health and Care Bill 2021-22 was introduced in the House of Commons on 6 July with the Second Reading scheduled to take place today, 14 July 2021.

The iHV, together with leading organisations as part of the Children and Young People’s Health Policy Influencing Group (HPIG), has issued to MPs and published today a collective briefing calling on the Government to take account of the specific needs of children in the proposed Health and Social Care reforms.

We hope that by coming together with so many leading organisations working with babies, children and their families, with one voice, we can draw attention to the gaps in the current proposed legislation as well as the considerable opportunities to ‘build back better’ for all children.

Alison Morton, Executive Director iHV, said:

“The Health and Care Bill provides an important opportunity to improve the quality of support that children receive through improved integration which needs to be maximised. At the moment, the system of support for families is fragmented at all levels, from national government to local delivery, and faces other challenges due to underfunding and workforce issues. We look forward to working with others to help shape the guidance that will ensure that children are at the heart of our health and care system – this will not happen by chance”.

HPIG welcomes the Government’s drive towards integrated services and greater collaboration within and beyond the health and care system, including the proposals to place Integrated Care Systems (ICSs) on a statutory footing. We believe integration and joint working are critical to improving health outcomes for infants, children and young people.

However, HPIG has significant concerns that the Integration and Innovation White Paper and the Bill have only considered the benefits of integration from the perspective of the adult health and social care systems. We cannot expect a system which has been designed with the needs of adults in mind to work effectively for children. The Health and Care Bill provides an opportunity to improve children’s health outcomes but, for this to happen, there must be concrete action to address its gaps.

HPIG briefing points and key questions

Key points from the briefing and associated questions for the Second Reading to ensure that children are at the heart of our health and care system:

  • A clear strategy for every child in every ICS
    • Question for Second Reading: How will Government ensure that every ICS prioritises infants, children and young people’s health?
  • Join-up at national policy level
    • Question for Second Reading: What plans does the Government have to ensure ICSs support the wider children’s policy agenda?
  • Supporting integrated services for children
    • Question for Second Reading: How will Government ensure that the children’s system benefits from legislation which facilitates integration across the adult health and social care system?
  • Providing sufficient support for successful implementation
    • Question for Second Reading: What are the Government’s plans to ensure the children’s system has the necessary workforce and funding to deliver high-quality integrated care?