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Preventative primary care measures ‘remain largely untapped’

A King’s Fund report has revealed that ‘the full potential’ of integrated health systems (ICS) ‘remains largely untapped because systems have not yet succeeded in fundamentally shifting their focus and resources towards prevention and population health

Chris Naylor and Luca Tiratelli’s report, ‘Driving Better Health Outcomes Through Integrated Care Systems (ICS)’ aims to understand the current influence of district councils within ICS, as well as advise on how this can be advanced to meet community health demands.

The report found that prevention ‘must be at the heart of integrated healthcare systems’ mission and purpose’.

The ‘assets’ of district councils are posed as the answer to these missed opportunities, providing the ‘golden thread’ to join up primary, secondary, mental health, social and community care services in the UK.

Deputy Leader of the LGA Independent Group, Hannah Dalton said: ‘districts have responsibility for housing, planning, leisure services and open spaces. It is districts which have the most levers to shape places to create healthier, happier communities.’

The report acknowledges that ‘the proportion of NHS resources invested in prevention and early intervention is inadequate’ and references ‘extreme service pressures’ as the reason why many district councils are not investing in long term strategies to prevent population ill health.

But, the report finds that ‘the immediate difficulties in meeting demand for services will never be solved if the bigger issues around population health remain unaddressed’ and points to ‘effective partnership arrangements’ between ICS leaders and district councils to pave the way for greater prevention.

It is not just about district councils having a voice in ICS, it is about utilising the extensive and entrenched connections that district councils have, as well as their knowledge of the communities they serve.

The report states: ‘this can be achieved by developing place-based projects that respond to the needs of local communities and tackle the key determinants of health they face. Given their small scale, closeness to communities and agility, district councils can provide an ideal testing ground for innovative preventive health work.’

Despite some inevitable challenges, the report finds ‘significant potential to improve health population outcomes and to reduce health inequalities by placing district councils at the heart of ICSs’.

Reflecting on the report, chief executive of north Kesteven district council, Ian Fytche said: ‘a great opportunity exists to build the relationships, systems, and the shared ambition to make the step change we need to address health inequality.’