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It investigates collaboration forms across ICBs, ICPs, places, and provider collaboratives, including coordination, incentives, conflict resolution, and commissioning mechanisms. Research draws on three in-depth case studies (Dec 2022–Sep 2023), constitution analysis of all 42 ICBs, and quantitative routine-data impact estimation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-architecture-of-system-management-report-2022-2023/296861/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-architecture-of-system-management-report-2022-2023/296861.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-18",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What does the study investigate in Integrated Care Systems?","Question",{"text":113,"@type":114},"It investigates how governance, accountability, and decision-making arrangements are developing to support system goals, including collaboration forms across ICBs, ICPs, places, and provider collaboratives.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What research methods are used?",{"text":118,"@type":114},"The study uses three in-depth case studies across the same ICS, constitution analysis of all 42 ICBs, and quantitative analysis of routine data to estimate impacts on selected health outcomes, with fieldwork from December 2022 to September 2023.",{"name":120,"@type":111,"acceptedAnswer":121},"Which tracer issues guide parts of the research?",{"text":122,"@type":114},"The research addresses questions through two tracer issues: elective recovery and hospital discharges.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},296861,1789738007,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":130,"read_time":145,"preview_page_count":4},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","NIHR Policy Research Unit in Health and Social Care Systems and Commissioning (PRU HSSC)  \nReport: The Architecture of System Management (2022-2023) Date of original report December 2023  \nRevised in accordance with peer reviews October 2024  \nContact: Professor Pauline Allen ( [Pauline.Allen@lshtm.ac.uk](Pauline.Allen@lshtm.ac.uk))  \nResearch Team  \nDr Marie Sanderson¹  \nDr Dorota Osipovic¹  \nDr Christina Petsoulas¹ Professor Pauline Allen (PI) ¹ Dr Yui-Shing Lau²  \nProfessor Matthew Sutton²  \nThis report represents the findings from independent research commissioned by the Department of Health and Social Care and was carried out by the Policy Research Unit in Health and Social Care Systems and Commissioning (PRU HSSC, previously PRUComm), and is a collaboration between the University of Manchester, London School of Hygiene & Tropical Medicine and University of Kent. PRU HSSC is funded by the National Institute for Health Research (NIHR) Policy Research Programme (Ref: PRU-02-07) . The views expressed are those of the authors and not necessarily those of the Policy Research Programme, NIHR or the Department of Health and Social Care.  \nAcknowledgements:  \nWe are grateful to our case study respondents for giving up their valuable time to be interviewed.  \n¹ London School of Hygiene and Tropical Medicine ² University of Manchester  \nExecutive Summary  \nStudy aims, objectives and methods  \nSince 2015 there has been an increasing emphasis in the English NHS on developing geographically based partnerships (Integrated Care Systems or ICSs) across the NHS and local government. There are 42 ICSs in the English NHS. The Health and Care Act 2022 gave ICSsa statutory basis consisting of an Integrated Care Board (ICB) (focused on integration within the NHS and accountable for NHS resources) and an Integrated Care Partnership (ICP)(focused on integration between NHS, local government and wider partners) . ICSs were set the four objectives of improvement of outcomes, tackling inequalities, enhancing productivity and value for money, and supporting broader social and economic development. ICSs function ina complex layered institutional landscape collaborating with a mixture of statutory bodies and non-statutory partnerships, operating at place, system, pan system and provider collaborative scale, with freedom to agree local system arrangements. ICSs are expected to achieve their ends through a collaborative approach, with significant delegation to place level and/or provider collaboratives, and partnership working with bodies which they do not have the power to direct.  \nThis research investigates how governance, accountability and decision-making arrangements are developing to support the achievement of system goals. The research questions of the study are:  \n• What are the nature and purpose of the forms of collaboration in existence within systems, including the developing provider collaboratives and place based collaborations?  \n• How are governance structures and leadership arrangements developing to facilitate coordination between the ICB and ICP, and between the ICS, partner organisations (statutory, independent and community-based, including local authorities), and places and provider collaboratives?  \n• How is decision making evolving in the ICS? In particular how are differing priorities across places, provider collaboratives, systems, individual organisations and from national bodies being reconciled, how are decisions being made in the event of disagreement between members, and how are conflicts of interest being addressed?  \n• In the light of the proposed new statutory responsibilities of the Health and Care Bill (now the HCA 2022) and the proposed System Oversight Framework, how are accountability relationships developing (both within systems and with national regulators), and creating clear accountability for and facilitating the achievement of, system aims?  \n• How are local and national incentives for collaboration, includi","cbCaigaGd2SPAlIg","https://ap.wps.com/l/cbCaigaGd2SPAlIg","pdf",2036803,276,"English","# Executive Summary\n## Study aims, objectives and methods\n## Summary of findings\n## Collaboration within systems","[{\"question\":\"What does the study investigate in Integrated Care Systems?\",\"answer\":\"It investigates how governance, accountability, and decision-making arrangements are developing to support system goals, including collaboration forms across ICBs, ICPs, places, and provider collaboratives.\"},{\"question\":\"What research methods are used?\",\"answer\":\"The study uses three in-depth case studies across the same ICS, constitution analysis of all 42 ICBs, and quantitative analysis of routine data to estimate impacts on selected health outcomes, with fieldwork from December 2022 to September 2023.\"},{\"question\":\"Which tracer issues guide parts of the research?\",\"answer\":\"The research addresses questions through two tracer issues: elective recovery and hospital discharges.\"}]","The Architecture of System Management - Report 2022-2023 | PDF",696]