ACOs/ICS – Letter to County Councillors on the Health and Wellbeing board

Dear Health and Wellbeing board members, 


I understand there is an ‘update’ on the Integrated Care System as item 9 on the agenda for this week’s Health and Wellbeing board meeting. I understand that in Devon the Health Scrutiny Committee has called for a stop to the setting up of an Accountable/Integrated Care System due to start in “shadow” form as of April 2018.


If Buckinghamshire, as one of the First Wave of Accountable/Integrated Care set-ups is due to become an ICS from the start of this financial year, we urge the council to halt proceedings immediately for the same reasons that Devon County Council now see as urgent.


There is a complete lack of transparency in what the ICS actually means for the public, local authority and NHS Organisations. There has been no clear consultation with the local population about the proposed changes to our local health and social care services.


As I am sure you are aware, there are currently two judicial reviews challenging the lawfulness of the formation of ACOs and new models of care using the NHS England Accountable Care Organisation Model contract introduced in August 2017.


Major concerns against ACOs/ICS include:

-handing large amounts of public money to non-NHS organisations 

-allowing more non-NHS organisations to control health & social care with contracts of 7 years or more

-the lack of public accountability

-the lack of public transparency and consultation

-How will integrated care work given that social care is means tested and NHS care is not?


All these questions need further scrutiny and public answers before setting up an ICS. In halting their process, Devon Scrutiny Committee are to be applauded for their decision and Buckinghamshire County Council should consider a similar response.


Of the 10 planned “First Wave” regions being fast-tracked to set up Accountable/Integrated Care both Greater Manchester and Dudley have publicly stated that they have put their plans on hold due to the legal challenges facing NHS England and the new contract.


Given that NHS England have now agreed to holding a national public consultation on Accountable Care and that the courts may soon decide that setting up Accountable Care models are unlawful we would urge the council to consider their responsibility to local tax-payers and the costs of having to reverse such a system in the event of it being identified as unlawful.

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