System Development

26th February 2022

What is System Development?

The formal establishment of Integrated Care Systems provides a real opportunity to transform ways of working to improve the health and wellbeing of local populations, build sustainable health and care services and to create truly integrated services so that patients experience high-quality, joined-up care.  However, transition to this new model has created some new challenges for all the organisations across these systems, with examples that include:

  • Integrated Care Boards (ICBs) need to look beyond and start to shift focus from safe transition (from CCG to ICB) to how they can enable and support system transformation.
  • Systems need to progress governance and assurance processes to genuinely enable them to embed the principle of subsidiarity whilst retaining effective arrangements and controls for decision-making, finance, risk, quality and performance. They also need to establish how they will go about discharging their statutory duties under these new ways of working.
  • System partners need to work together to develop, agree and implement system strategies for delivering sustainable, high-quality health and care.
  • Providers need to continue to build collaborative ways of working across both place and system footprints and create the time and space to enable relationships and trust to develop. This engine room for service transformation needs to agree and deliver service change priorities.
  • Organisations within the ICS must change their operating model to accommodate working over new, larger geographies.

How we can support

The TU has been working with systems to effect system transformation for many years with the type of support we provide including:

  • Support to develop and author key strategic outputs (including system-wide strategies and plans) informed by relevant guidance/regulation, local insight, and wide scale stakeholder engagement.
  • Development of new target operating models that embed the principle of subsidiarity and that provide clarity on how organisations will functionally operate in the new system.
  • Development and maturing of provider collaborative boards/other collaborative working arrangements to enable decision-making around service transformation priorities and to oversee delivery of service transformation programmes.
  • Implementation of new operating models for quality and assurance.
  • Supporting the development of Places as they mature.

Our services are supporting system leaders, provider organisations and places to adapt and respond to new roles and responsibilities and to working in news ways with new accountabilities.

Case studies


In anticipation of transition to a statutory Integrated Care Board, Surrey Heartlands ICS Executive commissioned…



Shropshire, Telford and Wrekin (STW) Integrated Care System serves a population of around half a…


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