We are thrilled to announce we have commissioned and supported the Future Health Research Centre with the launch of a new report, which identifies 16 health systems under high levels of pressure across both primary and secondary care going into this winter.

Analysis from NHS data sources including appointment access, waiting times and ratios of staff to patients is used to look at relative pressures between new Integrated Care Systems (ICSs), established in July 2022 and now responsible for regionally managing health services.

Each of the regional ICSs are ranked for six key metrics: the number of appointments per head of population, the number of appointments per GP, the percentage of same or next day appointments available, the percentage of appointments that were booked over 21 days of initial contact, the number of patients who ranked their experience as fairly poor and the number of A&E attendances due to no GP appointment availability.

The research revealed that Kent and Medway is the NHS region under the greatest relative pressure, ranking in the top ten for four of the six index metrics. It had the second highest appointments to GP ratio, the fifth highest number of patients recording a ‘poor’ or ‘fairly poor’ experience, as well as ranking tenth for the number of patients unable to see a GP resulting in going to A&E.

The top ten ICSs identified as the most under pressure were:

1. Kent and Medway
2. Leicester, Leicestershire and Rutland
3. Bedfordshire, Luton and Milton Keynes
4. Sussex
5. South Yorkshire
6. Gloucestershire
7. Derbyshire
8. Mid and South Essex
9. Dorset
10. West Yorkshire

By contrast a similar number of systems are under low relative levels of primary and secondary care pressure. These include Bristol, North Somerset and Gloucestershire, Buckinghamshire, Oxfordshire and Berkshire West, Coventry and Warwickshire, Hertfordshire and West Essex, Staffordshire and Stoke on Trent, Suffolk and North East Essex.

We have supported Richard Sloggett, the report author to collate a number of recommendations following the findings of the research:

This report, Under pressure: an analysis of primary care pressures facing Integrated Care Systems at launch, argues that the introduction of the following would all support the ambitions within the Fuller report to be realised:

• Accountability – Including measures within the new national oversight frameworks for Integrated Care Systems, such as the System Oversight Framework, that properly assess the role of primary care in ICS decision making. Also ensuring that system oversight is both proportionate and takes into account the different healthcare needs of ICS populations and the impact of the pandemic
• Funding – A new funding formula for primary care that properly takes into account levels of deprivation and a review of primary and secondary care financial flows to ensure that payment mechanisms are flexible and support integrated working arrangements
• Workforce – Tackling issues with NHS pensions to support workforce retention and providing greater flexibility to local teams regarding recruitment through the Additional Roles Reimbursement Scheme (ARRS)
• Capital – Re-prioritising healthcare capital spending to ensure capital funding is available for primary and community care and to support more integrated service transformation. This could include a proposed Community Health Infrastructure Fund
• Data – Utilise the Digital Health and Care Plan and the efforts during the pandemic to reduce bureaucracy in data sharing and enforce action on suppliers who do not conform to minimum standards. Streamline national health technology funding into a health data infrastructure accelerator that enables systems to join up health data more quickly and easily
• Regulation – Ensuring that new system level service regulation through the CQC Single Assessment Framework clearly engages with primary care leaders, particularly Primary Care Networks

These actions from national bodies will provide an enabling environment for regional and local systems to deliver the changes and improvements in care needed.

To read the report in full visit: https://www.futurehealth-research.com/new-future-health-research-identifies-the-nhs-regions-under-most-pressure-this-winter/