8.3 Strategic partnerships
Analysis for this programme indicates that there are currently 22 ICBs that interact with the 37 baseline county and unitary authorities. On average, these ICBs each interact with 2.73 authorities. If every county area analysed in this programme were to disaggregate county council services and merge with neighbouring unitary authorities (where applicable), with an average population of 500,000, this would result in nine additional upper-tier local authorities (forming 46 new authorities compared to the baseline of 37). This would result in an average of 3.14 local authorities per ICB, meaning that on average nine of these 22 ICBs would interact with an additional authority. This analysis has been carried out prior to the new ICB clusters being confirmed and as such does not take this into account.
With shifting boundaries of local authorities and ICSs, there is a risk and an opportunity in aligning new units of service delivery. This includes alignment and partnership working with wider partners, such as the police, the voluntary sector, and private service providers. LGR presents an opportunity for partners to better align around place, and critical to this will be the number of partners required to Minimising the number of partners involved, and the number of transitions and handovers required between services helps maximise effectiveness of place-based working and reduces quality of care risks introduced through handovers between organisations. Practically this means ensuring boundaries are consistent with partners at a neighbourhood level. If this is not achieved (and if police, VCS, health, social care, and schools all cover different footprints), then risks might include multiple handovers between different organisations and commissioners, an work together, and the potential for partnerships to be co-terminous. increased likelihood of there being gaps in care support and ultimately a more complex and less efficient system.
Case Study 6
As an example, in one county area, one ICB currently only interacts with a county council and one of its neighbouring unitaries. For 85% of its complex discharges, it works with one authority. This county council analysed the implications of disaggregation into two or three unitaries. This would mean that the number of authorities this ICB interacts with would increase from 2 to 3 or 4 and so, in the worst case, this would potentially double the number of meetings and staff required to handle these interactions.
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