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Integrated care: guest blog from NHS Confederation

The Inequalities in Health Alliance is a coalition of more than 250 organisations, convened by the RCP, who campaign for a cross-government strategy to reduce health inequalities. This blogpost from NHS Confederation is part of a series by member organisations. NHS Confederation policy and delivery manager Ruth Lowe works within the Confederation's ICS Network and leads on health inequalities policy.

The NHS Confederation has been pleased to be a member of the Inequalities in Health Alliance since its foundation. Our members - health and care leaders across the whole NHS system - know that tackling health inequalities is critical both to people’s quality of life, our economy and the future sustainability of our health and care services.

Evidence on the impact of health inequalities is clear, so as a membership organisation we focus on providing practical support to our members to help them tackle inequalities in their local communities.

With the advent of Integrated Care Systems, NHS leaders are thinking more than ever before about the wider determinants of health. Since ICSs became statutory bodies in July 2022, our ICS Network members from across all 42 systems have been deeply concerned about the impact of the cost of living crisis on the communities they serve. This led us to set up our Cost of Living Hub to set out the policy issues linking cost of living and health; as well as providing best practice examples for our members to adopt and use to support their residents. Since we made the Cost of Living Hub in October 2022, cost of living featured in more than 85% of integrated care strategies produced by ICS.

Later this month we’ll be publishing a toolkit for ICS leaders to help inform decision making on funding targeted to address inequalities, supporting them in their second statutory purpose. This will be part of a project we’ve undertaken with Leeds Beckett University, Clarity and the Care Quality Commission. The toolkit is underpinned by research that we undertook with 86% of health inequalities leads in ICBs; where we sought to understand the range of approaches systems took to address inequalities, so that we can support systems to learn from each other, scale innovative approaches, and model leadership behaviours.

We also run an ICS Health Inequalities Reference Group – a group of ICS leaders who meet every other month to discuss policy and improvement updates, opportunities and challenges and inform the NHS Confederation’s health inequalities work programme. More broadly, we also run a Public Health and Integrated Care Systems Forum (PHIF), jointly with the LGA and the Association of Directors of Public Health – on which we have a representative from the RCP. This group acts as a conduit between local and national public health functions and systems and meets quarterly.

Also, in partnership with the LGA we run the Integrated Care Partnership (ICP) Forum. ICPs are an ICS Committee that bring together NHS organisations, upper tier local authorities, the VCSE sector and others with a role in influencing the wider determinants of health and wellbeing for individuals and communities.

We bolster this practical support to our members by making their voice heard in the national media and in parliament on issues including support for rising energy costs, the Major Conditions Strategy and the need for the rate of Universal Credit to cover the cost of what people need to live.  We continue this work in this important election year and look forward to continuing working with the Inequalities in Health Alliance to raise the profile of this critical issue and ultimately to tackle the structural drivers that are cutting lives short in Britain today.