31 March 2025
This file can be downloaded as a pdf here.
In Cornwall our Integrated Care Board (ICB) is doing a good job of integration. It has produced a comprehensive and well-researched Joint Forward Plan, to which staff of the two NHS Trusts in Cornwall and Cornwall Council’s Public Health and Social Care departments and many GPs have contributed, along with a very wide range of voluntary organizations, community groups and people with lived experience from across the county and the Isles of Scilly.
In Cornwall progress on its Joint Forward Plan shows what can be done on the ground. To start, a number of innovative facilities were set up, with an emphasis on personalized care. As well as technological upgrades (for breast screening, X-ray facilities and elective surgery), these included specialized facilities for particular groups of people: a sensory healing garden for critically ill patients, and supported feeding at home for children and young people with eating disorders. And for ‘people most at risk of inequalities’, community wellbeing workers were recruited who lived in the disadvantaged neighbourhoods they were supporting.
These and other elements of the Joint Forward Plan provide local people with opportunities to take part in improving their own physical and mental health and that of other people. This applies across Cornwall. (West Cornwall in particular includes many wealthy areas but also three areas which on the national Index of Multiple Deprivation are among the 15 most deprived in England.)
The wide range of contributors and their inputs and the content of the Joint Forward Plan itself show the value of an organization like our ICB that can bring together contributions from many sources, learn from them, and formulate a plan for care that is an integrated response to local circumstances. It is hard to see how any other body could have done this.
So our ICB is showing how the idea of ‘integration’ can be brought to life. In the process it has effectively become a driving force behind a mass campaign for better health in Cornwall.
But today this campaign may be at risk. The NHS is currently in a state of upheaval. Its governing body, NHS England, is being abolished. ICBs have been instructed to reduce their running costs by 50%, on top of 20% cuts ordered earlier. These round-number targets have never been explained or justified. It looks as though they have been plucked out of the air by Treasury accountants.
In part the latest target may be met by pensioning off people in ‘non-frontline’ roles such as commissioning, issuing and monitoring contracts, and performance management. It is crucial to all of us who live in Cornwall that our ICB does not sacrifice staff who are working on implementing and updating the Forward Plan.
I would add that Cornwall’s campaign for better health is not only for us: it is a flagship for the whole country. But right now it is up to us to to keep it going!