Independent review of ICS encourages health promotion

The Hewitt Review recommends giving integrated care systems more autonomy and unlocking the potential of primary care


The AOP has welcomed a focus on prevention within a new independent review into integrated care systems (ICS).

Former health secretary, Patricia Hewitt, was commissioned last year by Chancellor Jeremey Hunt to undertake a review into the oversight and governance of ICSs.

Her report, which was published on 4 April, recommends shifting from a focus on illness to the promotion of health.

The review calls for the share of total NHS budgets at ICS level going towards prevention should be increased by at least 1% over the next 5 years.

Hewitt highlights that “NHS funding remains over-focused on treatment of illness or injury rather than prevention.”

The review also calls for the potential of the primary care and social care workforce to be unlocked.

“In order to make the promise of ICSs a reality, we also need to pull down some of the barriers that currently exist for primary care, social care and the way we train the health and care workforce,” Hewitt observed.

The report highlights that on 1 April 2023, integrated care boards took on delegated responsibility for commissioning all community pharmacy, optometry and dentistry services for the first time.

“Instead of each element of primary care being treated as a separate silo, ICBs now have the opportunity – and the responsibility – to work with all elements of primary care to achieve the accessible, high-quality and integrated services that residents and local communities need,” the review stated.

AOP policy director, Carolyn Ruston, highlighted that the focus of the Hewitt review on prevention alongside improving NHS efficiency is “vital for our UK health system.”

“Given our ageing population and the increasing long term health issues caused by lifestyle and other social factors, the recommended shift towards preventative services over treatment for illness opens opportunities not only for a healthier population but to utilise the breadth of skills in the primary and social care workforces,” she said.

“It is an approach long advocated for by the optometric workforce – who are highly trained, highly skilled professionals equipped on every High Street across the UK and who are ready to have a wider role in prevention and diagnostics, and improve patient access by reducing the current backlogs we're seeing in hospitals," Ruston shared.

“Over the coming weeks and months the AOP will continue to work with sector and system partners such as the NHS Confederation, to take forward what this will mean for our profession in the future,” she concluded.