The introduction of Integrated Care Systems (ICS) marks a major shift in the way health and care is planned and delivered across England. But what does this really mean in practice? What will change — and what needs to happen for the voluntary sector (VCSE) to be fully embedded in these new structures?

This article draws on our experience working on NHS England’s “Embedding the VCSE sector in ICS” programme — with Lev as part of NAVCA’s associate consultant team, and Susannah as the Integrated Care Partnership Director for Suffolk and North East Essex ICS.

A quick jargon check

• ICS (Integrated Care System): Brings together NHS, local government, voluntary and independent sectors to plan and deliver health and care collectively.

• ICB (Integrated Care Board): New statutory NHS organisation replacing CCGs, working at system and place levels.

• ICP (Integrated Care Partnership): Statutory committee that connects all ICS partners as equals, jointly convened by the NHS ICB and upper-tier local authorities. It sets strategy and aligns with local Health and Wellbeing Boards.

What’s actually changing on 1 July 2022

Service providers shouldn’t fear losing local commissioning overnight. The first year will be transitional, with a strong emphasis on place-based working.

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• Clinical pathways may evolve across ICS areas over time.

• Most day-to-day commissioning will continue at place level.

• Transitional arrangements will allow issues to be addressed as they arise.
   

This is not about stripping away local relationships, but about building system-wide collaboration.

Making the voluntary sector central, not peripheral

Suffolk and North East Essex was among the first systems to adopt the ICS model. At its core, the partnership is defined by:

• Strong, positive relationships between health and care leaders

• Courageous joint action to address problems

• A genuine “can do” attitude

• VCSE engagement at every level — from neighbourhoods to place to system

Seven habits for effective VCSE integration into ICS

1. Equal means equal

Real partnership is about more than seats at the table. It’s about sharing power.

• Equal voice and representation

• Equal influence and access to information

• Equal support and investment

• Equal expectations and opportunity

2. Tear up the rule book

ICSs are not business as usual. They’re designed to be new partnerships focused on local needs, less competition and more collaboration.
As Rob Webster (West Yorkshire Health and Care Partnership) said:

“They’re not like anything that’s gone before... This isn’t the way this is going to work.”

Non-competitive models such as alliance contracting show what’s possible.

3. Relationships matter

Successful partnerships depend on trust, shared values and joint goals. That requires time, investment and nurturing — moving from transactional arrangements to system thinking and teamwork.

4. Walk the talk

VCSE leaders must not just be invited to listen — they must be able to shape the conversation. Equal relationships rely on honesty and mutual respect.
Key principles:

• Keep it simple

• Respect time

• Match effort

• Keep your word

• Be honest and consistent

5. Lead and cede

“People don’t ‘buy’ what you do, they buy why you do it.” – Simon Sinek

Start with why before how and what. Build shared purpose first, then design strategies together.

6. Strength lies in diversity

The VCSE sector is wonderfully messy and diverse — and that’s its strength. Organisations exist because they meet real community needs. Alliances must celebrate and harness this diversity, ensuring all voices — including marginalised communities — are represented.

7. The future is in our hands

Many of us have seen multiple restructures. But ICS represents a genuine opportunity to do things differently. The pandemic showed what’s possible when barriers are removed. Now is the moment to build on that momentum.