In anticipation of transition to a statutory Integrated Care Board, Surrey Heartlands ICS Executive commissioned a partnership of the TU and Prospect Business Consulting to support co-production of a new ICB operating model.
Our innovative approach sought to align a programme of executive leadership and organisational development alongside the co-production of the new operating model. Wide-scale, cross-sector stakeholder involvement ensured local ownership and strong progress in building and evolving working relationships between system partners. Embedding an operating model toolkit has enabled self-sufficiency within the system to continue to evolve and expand the operating model development.
As a relatively mature ICS, Surrey Heartlands had made excellent progress in advancing their Places and working collaboratively. However, they recognised the need to further mature their thinking around how best to apply the principle of subsidiarity so that they could empower their four Places to design and deliver care that best meets the needs of their population. They also wanted to maximise opportunities to work at scale, where appropriate, to enable them to tackle health inequalities, create a sustainable and resilient health and care system and drive digital integration.
With no ICS having yet transitioned or having developed their operating model there was no precedent or blueprint to follow. This work was also set against a backdrop of a CCG staff restructure, surge of the omicron COVID-19 variant as well as the need to keep pace with emerging legislation, policy and guidance.
Recognising that we were working within an innovation space, the agreed approach sought to employ tried and tested methods for developing an operating model from the worlds of manufacturing and business. The approach was tailored in accordance with the ICS design guidance. The work programme comprised:
Fifteen functional workstreams were supported to work collaboratively with a broad range of stakeholders from across the system to produce their individual operating models. Interdependencies were subsequently mapped and the whole ICB operating model assembled.
Functions included in the operating model are: Clinical Leadership, Commissioning & Contracting, Communications & Engagement, Digital, Data & Technology, Facilities & Estates, Financial Recovery, Governance & Assurance, Information Governance, Multi-professional Leadership, People & Culture, Place-making, Provider Collaboration, Quality, Strategy & Transformation, System Resilience (System Coordination Centre).
The resulting operating model was designed so that:
Implementation of the operating model has now transitioned into ‘business as usual’ arrangements for each of the functions. The operating model is expected to evolve as additional ICB duties are delegated, further policy and guidance emerges and their strategy and priorities develop. Future developments may also expand to include the Integrated Care Partnership functions.
“Our new operating model is an important development that will enable Surrey Heartlands to bridge CCG-to-ICB transition and shift to a more transformative state, helping us to realise our ambitions of working collaboratively with all our system partners.
It was vital that the work was co-produced with system partners and led by teams working in the functions concerned; ensuring implementation of the resulting model is owned by staff and has partner buy-in. The development process in itself has accelerated the building of relationships and new ways of working across system partners.
The resulting operating model is of exceptional detail, covers a diverse set of functions and provides the blueprint for how we will operate in the new world.
The support provided by Prospect and NHS Transformation Unit was key to challenging our thinking, brokering conversations, and supporting our teams to follow a well-structured process.”
Michael Pantlin ICS Chief People and Digital Officer