The Hewitt Review: An Independent Review of Integrated Care Systems

The Hewitt Review, a comprehensive independent review of integrated care systems (ICSs), has been published today. The much anticipated review proposes greater freedoms and local autonomy, a focus on promoting population health, and unlocking the potential of primary and social care.

The review was commissioned by Chancellor Jeremy Hunt in November 2022 and has been informed by the views of a range of groups including leaders from the NHS, local government, those representing patients, social care providers and the wider community.

The review argues that ICSs represent a vital opportunity for the transformation of health and social care. It states that we must transform how we deliver health and care services in order to achieve better population health & wellbeing.  The review argues that the creation of ICSs provides a real opportunity to build upon this approach and suggests the need for a more holistic approach to improving the nation’s health.

“Integrated Care Systems have the potential to transform the model of care to achieve better experience and outcomes for the people we serve. The Hewitt report hits the mark by calling for a shift in emphasis towards prevention, through greater local autonomy, a simple set of targets, investing in primary and social care, and long-term financial planning. Aqua welcomes and encourages the recommendations from Rt Hon Patricia Hewitt and are proud to support colleagues to take these forward.”

– Dr Neil Turton, Aqua

Six key principles were identified that the review proposes allow ICSs to thrive:

1. collaboration within and between systems and national bodies
2. a limited number of shared priorities
3. allowing local leaders the space and time to lead
4. the right support
5. balancing freedom with accountability
6. enabling access to timely, transparent and high-quality data

The Recommendations

The review recommends greater freedoms for ICSs, with fewer shared targets and a small number of priorities. It also states that giving local leaders more flexibility in their decision-making in primary and social care will better enable them to improve outcomes in the communities they serve.

Rt Hon Patricia Hewitt outlines in the review the need for renewed accountability from ICSs, putting forward strong support for an enhanced role for the Care Quality Commission (CQC). The review recommends that the CQC and ICSs work together with a long-term approach to system inspections, allowing the CQC to support ICSs in their development.

The review also recommends changes in the way funding is allocated to ICSs, calling for an end to smaller ‘pots’ with extensive reporting requirements. The review proposes that funding should become largely multi-year and recurrent to enable ICSs to achieve their long-term outcomes.

The review summarises by stating: “Effective change will require the combination of new structures with changed cultures. Everyone needs to change, and everyone needs to play their part”.

Read the full review here