Local authority engagement in Integrated Care Systems – Housing and Place-Based Partnerships

Background: The legislative shift towards integrated care systems (ICSs) in England has made local authorities (LAs) statutory partners, with roles and responsibilities which now go beyond previous jurisdictions. Although these roles and the systems which LAs operate in are complex and changeable, it has been anticipated that more collaborative opportunity would emerge, and that health and care partners could benefit from specific LA insight whilst LAs developed in similar ways. Understanding the local social determinants of health is key to attempts to manage population wellbeing and therefore an effective relationship between different sectors within the system is crucial.

Approach: This paper explores this through qualitative interviews with LA housing partners and attempts to gain insight into the level of engagement within and between sectors. The data were thematically analysed and significant themes included: Type and extent of collaboration, Local Authority structure, Geography, Funding, Housing, Barriers to collaboration or integration and Factors that facilitate collaboration.

Results: Findings revealed a range of cultural, structural and financial barriers which will need to be acknowledged and negotiated in order for reciprocal potential to be realised. Efforts to facilitate integration will need to align with structural complexity where possible. In order for locally focussed integrated care to effectively serve the communities and neighbourhoods as intended in policy, aspects such as housing and equivalent social determinants of health will need to be more well understood, and both structurally and culturally enabled.

Implications: Understanding the value of working beyond conventional boundaries whilst negotiating the perceived difficulties which come with translating and adapting is likely to result in more efficient partnership working and improved outcomes for service users. However the reduction in ICS running costs is likely to make integration beyond core statutory commitments more difficult. Although there is some legislative requirement to collaborate with LAs, specific relationships which respond to population need may be harder to maintain. There is however potential for existing collaboration to supplement and potentially offset the impact of these cuts. A closer consultative relationship between LAs and ICS colleagues may help navigate a period of turbulence and uncertainty. This work offers an opportunity to understand the nuances of cross sector working and is likely to be of relevance across equivalent international integrated care contexts.