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33-630: One Health Group operates in conjunction with a number of NHS commissioners across the north of England, with services directly commissioned by NHS trusts and provided through the NHS e-Referral Service . The company works at over 30 clinics and performs surgeries at private hospitals owned by Circle Health , Spire Healthcare , and Practice Plus Group One Health Group is a member of the Independent Healthcare Providers Network One Health Group

66-567: A complex, collaborative governance arrangement" Three more areas were designated in June 2019, and four more in May 2020 (Hertfordshire and West Essex, Humber, Coast and Vale, South West London, and Sussex ), bringing the total to 18. Nineteen NHS minority ethnic leaders demanded in March 2021 that the executive officers (not just the non-executives) in the 42 emerging ICSs should be representative of

99-527: A consortium of 20 GP practices agreed a business plan for £12.3 million of services for 2018–19. The contract for Guildford and Waverley in 2016 was one of the first major community services contracts to be won by a private company. Virgin Care won the contract, in partnership with Royal Surrey County Hospital NHS Foundation Trust and Surrey County Council . However it was suspended in February 2017 because

132-488: A first wave in the development of what were then called accountable care systems . He said they "will bring together providers and commissioners to help break down barriers between primary, secondary and social care". They would be given up to £450 million between them in transformation funding over the next 4 years. The eight were: Greater Manchester was not included because it already had more advanced arrangements under its 2015 "devolution" deal. Surrey Heartlands began

165-587: A forecast deficit of £10.7m by the end of 2014/5. The company successfully challenged in October 2018 when they claimed they had been excluded from a contract given to the Integrated Dorking Epsom and East Elmbridge Alliance of which they had originally been part of. The Epsom Health and Care Provider Alliance, a partnership established in 2015 between Epsom and St Helier University Hospitals NHS Trust , Surrey County Council , CSH Surrey and

198-623: A programme of in-reach GPs in 2015, where GPs were placed in wards of the Royal Surrey County Hospital reviewing patients who had been admitted and advising on possibilities for discharge. Surrey and Borders Partnership NHS Foundation Trust provides mental health services. As a result of the Transforming Community Services programme East Elmbridge and Mid Surrey PCT was required to needed to separate its provider and commissioning arms. It

231-750: A reduction in the provision of community hospitals in 2016. It expects a deficit of £35 million for 2016/7. East Surrey Clinical Commissioning Group was put under restrictions by NHS England in December 2015 because of a budget deficit of £24.7 million. In April 2016 the deficit was expected to reach £31.66 million for 2016/7, despite planned savings of more than £10 million. There are 128 GP practices in Surrey. The county has its own local medical committee . Out-of-hours services are provided by IC24 in East Surrey and by Care UK . In January 2016 it

264-474: A similar arrangement in 2018. In each area a provider or, more usually, an alliance of providers will collaborate to meet the needs of a defined population with a budget determined by capitation . There will be a contract that specifies the outcomes and other objectives they are required to achieve within the given budget over a period of time. This may extend well beyond health and social care services to encompass public health and other services. In Manchester,

297-415: A statutory basis, each with an approved constitution. On 1 July 2022, a total of 42 ICSs became statutory. There are more than 70 performance metrics by which they are judged, grouped into six "oversight themes": quality, access and outcomes, preventing ill health and reducing inequalities, leadership, people, and finances. The poorest performers will be put in a "recovery support programme", which will replace

330-654: A £62 million deficit. From 1947 to 1974 NHS services in Surrey were managed by the South-West Metropolitan Regional Hospital Board . In 1974 the boards were abolished and replaced by regional health authorities . Surrey came under the South West Thames RHA apart from Spelthorne which came under the North West Thames RHA. Regions were reorganised in 1996 and the whole of Surrey came under

363-543: Is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical area. The organisations involved include the NHS , local authorities, voluntary and charity groups, and independent care providers. The NHS Long Term Plan of January 2019 called for the whole of England to be covered by ICSs by April 2021. On 1 July 2022, ICSs replaced clinical commissioning groups in England. The Health and Care Act 2022 put these systems on

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396-486: Is at the forefront of this exercise and will be able to implement the draft voluntary contract, subject to the outcome of this consultation exercise. It is proposed that general practitioners will be able to sign fully or partially integrated contracts, and that fully integrated practices would give up their existing contracts to become salaried. A report from the Nuffield Trust in December 2021 found that there

429-615: The Health Select Committee in May 2018. They were described by Chris Ham as "coalitions of the willing" in 2018. He said that real progress had only happened in places where there was a history of collaborative working. He also commented that there was little guidance and so more latitude than is usually the case with national NHS initiatives. In January 2019 it was announced in the NHS Long Term Plan that by April 2021 integrated care systems were to cover

462-545: The clinical commissioning group was concerned whether it could deliver the specification for integrated services "with the key partners that had been identified in their bid submission". From 2018, services are provided by Royal Surrey County Hospital and Procare, the local GP Federation which will have a nine-year contract with an annual value of just under £14 million. Virgin Care will continue to provide services for people covered by Surrey Heath Clinical Commissioning Group's and those living in and around Farnham. There

495-578: The South Thames Regional Health Authority. The county had its own Area Health Authority from 1974 until 2000 when they were abolished. The county was divided into five district health authorities for East Surrey, Mid Surrey, North West Surrey, South West Surrey and West Surrey and North East Hampshire. West Surrey and North East Hampshire was abolished in 1994. Regional health authorities were reorganised and renamed strategic health authorities in 2002. The whole county

528-464: The UK since they had different governance structures and forms of service provision. It is proposed that systems employing general practitioners would have to meet the costs of their indemnity insurance. In September 2017 NHS England produced a handbook designed to support the creation of new payment models which are intended to remove the direct relationship between NHS activity and payment, improve

561-401: The alignment of payment for all providers within the care model and better incentivise prevention and wellbeing. In February 2018 it was announced that these organisations were in future to be called integrated care systems, and that all 44 sustainability and transformation plans would be expected to progress in this direction. The ten pioneer systems were described as nascent and fragile by

594-569: The desired results. On 1 July 2022 NHS England established 42 integrated care boards, covering the whole of England. Healthcare in Surrey Healthcare in Surrey , England was the responsibility of five Clinical Commissioning Groups : East Surrey, North West Surrey, Surrey Downs, Guildford and Waverley, and Surrey Heath from 2013 to 2020 when East Surrey, North West Surrey, Surrey Downs, Guildford and Waverley merged to form Surrey Heartlands CCG. The new organisation started with

627-677: The devolution in Manchester, bringing the NHS together with Surrey County Council . Ian Smith, who was also previously executive chair of Four Seasons Health Care and chief executive of the General Healthcare Group , was appointed chair of the Surrey Heartlands integrated care board in October 2021. Surrey Downs CCG, where 20% of the population is over 65 (expected to increase to 27% by 2025), are contemplating

660-478: The draft contracts for what were then called integrated care providers (ICPs) was launched by NHS England in August 2018 after the failure of two legal challenges to an earlier draft contract. The consultation said that this was not a new type of legal entity, but merely the "provider organisation which is awarded a contract by commissioners for the services which are within scope." Dudley clinical commissioning group

693-510: The ethnic diversity in their communities. They wanted to see ethnic diversity and inclusion a part of every NHS board's core business and that every system should develop a 10-year strategy, with annual milestones, for reducing inequalities. In July 2021 chairs had been appointed for 25 of the 42 NHS integrated care boards. 11 are women, and five have a minority ethnic background. The chairs must not be councillors or MPs, or to work for any of their ICS's constituent organisations. A consultation on

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726-511: The label of special measures . Each system is to set their own constitution, determine staff pay and can raise "additional income" but the chair must be approved by the Secretary of State for Health and Social Care . The areas covered by each ICS vary considerably by population and demographics. Population size ranges from 500,000 to more than 3 million people. Some have more than 10 upper-tier local authorities and some only one. Nearly 50% of

759-469: The leadership of Julia Ross, the Chief Executive of North West Surrey Clinical Commissioning Group . The three CCGs in Surrey Heartlands, Guildford and Waverley, North West Surrey and Surrey Downs appointed a single chief officer in May 2017. Their plan centres on new models of care in the community. Surrey Heartlands is to have a health and social care devolution style deal along the lines of

792-662: The neighbourhoods in Birmingham and Solihull are in the most deprived fifth of the neighbourhoods nationally, compared to 1% in Surrey Heartlands. NHS England produced a model constitution in July 2021, which systems are expected to use when developing their own arrangements. Each ICS must have an integrated care board with at least five executive directors and three non-executives. The boards must work with local authorities to create an integrated care partnership (ICP) committee for each system, to include local organisations such as

825-639: The objectives are specified over ten years. Keeping people out of hospital by moving services into the community is a common feature. NHS trusts , Clinical Commissioning Groups and local authorities in the new ACSs will "take on clear collective responsibility for resources and population health". The process was denounced by John Sinnott, Chief Executive of Leicestershire County Council in September 2017 as lacking any element of public accountability. He said that existing models in other countries were interesting but not relevant to democratic accountabilities in

858-525: The voluntary sector and social enterprises . The ICP works on prevention, wider social and economic factors affecting health, and reducing health inequalities. Each ICS is to have a community pharmacy clinical lead, funded by the Pharmacy Integration Programme for the first two years. Eight sustainability and transformation plan areas in England were named in June 2017 by Simon Stevens , chief executive of NHS England , as

891-433: The whole of England with a single clinical commissioning group for each area. Each one will be run by a partnership board with members from commissioners, trusts, and primary care. But it has been suggested that "All ICSs are structured differently as there is no fixed model for how they should be developed; and the leadership is defined in terms of roles and agents, with little to guide leadership practices and behaviours in

924-558: Was appointed the leader of the Frimley Health Sustainability and transformation plan footprint, which covers the areas of Bracknell and Ascot CCG, North East Hampshire and Farnham CCG, Slough CCG, Surrey Heath CCG and Windsor, Ascot and Maidenhead CCG. East Surrey and Sussex formed a separate sustainability and transformation plan area with Michael Wilson, the Chief Executive of Surrey and Sussex Healthcare NHS Trust as its leader, as did Surrey Heartlands, under

957-403: Was decided to establish a not-for-profit, limited liability company owned by local nurses and therapists called Central Surrey Health . This was the first community healthcare social enterprise to be "spun out" of the NHS, in 2006. It is now known as CSH Surrey. Surrey Downs Clinical Commissioning Group is undertaking a review into the future of the four community hospitals run by CSH because of

990-652: Was founded in 2000 by orthopaedic surgeon Derek Bickerstaff. as The Windsor Sports Injury Clinic Limited Adam Binns was appointed CEO in 2019. The company was the subject of an initial public offering on the AQSE Growth Market in November 2022, raising £1.5m. In 2023 the company was awarded contracts to provide services to Barnsley Hospital NHS Foundation Trust and University Hospitals of Derby and Burton NHS Foundation Trust . Integrated care system In England, an integrated care system ( ICS )

1023-539: Was part of Surrey and Sussex SHA. In 2006 regions were again reorganised and Surrey came under NHS South East Coast until that was abolished in 2013. There were originally five primary care trusts for the area but they were merged into one in 2005. The clinical commissioning groups took on the responsibilities of the former PCTs in April 2013. There are three plans for the county. In March 2016 Sir Andrew Morris , Chief Executive of Frimley Health NHS Foundation Trust ,

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1056-460: Was reported that some GPs in Crawley had closed their lists and that surgeries were having difficulty in recruiting doctors. The main hospital providers in the county are Frimley Park Hospital NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust . There is a joint venture Surrey Pathology Service established in 2012. Guildford and Waverley Clinical Commissioning Group organised

1089-415: Was very little evidence that integration policies across the UK – including pooling budgets and creating new integrated boards and committees – had dramatically improved patient experience, quality of services or supported the delivery of more care outside of hospitals. They warned that without concurrent investment in social care and broader public services, it was “very likely” further reforms would not yield

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