On Wednesday 5th July, Dr. Justin Varney, Director of Public Health Birmingham, delivered a virtual update to the VCFSE sector around Birmingham and Solihull Integrated Care System's 10-year Integrated Care Strategy (2023-2033). The presentation outlined:

• The ICS' vision and ambition
• The system of partnerships working to support the people of Birmingham & Solihull
• The differences the strategy hopes to make
• Metrics of success
• Five key clinical areas that will help improve life expectancy
• Priorities and next steps for 2023/24

The session was recorded, available for viewing at this link: 5th July 2023: Dr. Justin Varney presents the ICS 10-Year Strategy for Birmingham and Solihull

A short question and answer session was also held following the end of the presentation. Due to time, some questions could be answered in the session, but Dr Varney provided additional answers to these questions, which can be found at the end of this webpage.

Please see the following links for additional information about the Integrated Care Strategy:

Our Integrated Care Strategy 2023-2033: Birmingham and Solihull ICS

Developing our Integrated Care Strategy: Birmingham and Solihull ICS

The live chat from the virtual session can be downloaded here.

The slides from the virtual session can be downloaded here.

Additional Q&A Answers

- Can you tell us some more about how the process of selecting the delivery partners and how they expect to engage community groups in their delivery?

This will depend a bit on the project, the ICS has been refreshing the system approach to engagement and co-production and this will be published at some point in the next year. In the interim at a local level it is best to contact the Primary Care Network as the local place level, the details of the local PCN for where you are based is on the local GP practice website.

- How are you going to strengthen true collaborative working and remove/break-down artificial barriers at different levels- across the system, workforce and providers, plus take citizens, patients, service users, carers, families  along that journey?

See above

- What are you going to do to change silo behaviour and genuinely have people working collaboratively rather than politically protecting their own organisations and budgets?

This will take time because it takes trust and also accountability on all sides and there is work starting to explore and develop this.

- Has the impact of high staff turnover in the region been looked into?

The ICS has a workforce board which is looking at staff recruitment and retention. In health and social care there is quite a lot of movement between different organisations so turnover can be a bit of a blunt tool, so it’s important we look in a broad way at workforce.

- Is there any research or data that might support the delivery of the strategy?

The strategy was based on both area joint strategic needs assessments and there is a research and evaluation strand in the delivery plan being developed by the ICS as part of the Joint Delivery Framework.

- In the current plan do you think there is likely to be sufficient investment in cost-effective evidence-based prevention strategies to reduce lifestyle related chronic disease, particularly in respect of those communities with the greatest health inequalities.

Prevention is key to achieving the ambitions of the strategy and this needs to happen across the life course through a whole system approach which takes in account how and when we can enable people to act themselves, where universal support is needed and where targeted support is needed.

- How will the strategy be monitored and adjusted as necessary?

There will be an annual review of progress report by the Directors of Public Health of Birmingham and Solihull and the indicators are reported on a public dashboard at?

- Great to see suicide reduction in there. However, how can we prove suicide numbers are a direct reflection of service provision? Wider societal factors are known to have a huge impact.

Suicide, like other clinical outcomes such as heart attacks or strokes, are just the tip of the iceberg and so it is important we look at the pathway as a whole from prevention to end of life and consider the opportunities for action. These opportunities are both in the context of health and wellbeing activities and interventions like brief advice on physical activity and in the context of the ICS work to support increasing household income and reducing poverty by becoming a ‘Real Living Wage System’. The Strategy clearly references the need to consider the wider determinants and this work will be lead primarily through the two Health and Wellbeing Board.

- In terms of inequality - where do you see autism fitting? We don't like to describe it as a disability (because we regard it as a difference) so often our service users don't fit conveniently into any definition of inequality, despite being disadvantaged by the neurotypical world in many ways.

This is a good example about the complexity of language around identity. One of the challenges of being such a large system and one of the benefits is the diversity of our population and this means we are large enough to be able to serve communities which in smaller areas would be lumped together. It has led us to go beyond some of the simplistic language like disability and ethnicity and dig a bit deeper to understand different communities and the inequalities that affect them and you can see this in the community health profiles that Birmingham City Council have produced. This is a journey and one that we will as a system in partnership need to continue to explore.

- Are the integrated systems you spoke about currently implemented if not how soon will that happen?

There are some examples where integration is already happening to varying degrees, this ranges from some of the work in adult social care on integrated support for older adults in the community through the integrated services being delivered through children’s centres and the partnership of Forward Thinking Birmingham. There is more to do but some of this is already live and happening.

- Also, would the e-learning for health and social care on behavioural change be made available to commissioned partners?

We are working towards this, some of the training is already free to providers through the National Centre for Smoking Cessation Training for example on brief advice for smoking cessation and some providers can already access free training on e-learning for Health, so it is worth checking these out to see if you can access them already.

- How can we overcome language barriers? We have been providing emergency interpreting training to Ukrainian speakers and trained healthcare professionals in working through an interpreter. How could we upscale the work to improve health outcomes for patients with English as an additional language?

The NHS commissions some language interpretation services and this is something that may be reviewed in the future, there are options for the ICS to also consider around software that provides translations of medicine labels for example. There is a recognition that language is a barrier and needs to be considered.

- Why is Self-harm not included?

Suicide and self-harm rates are included as an indicator metric on page 28 of the strategy.

- The challenge in a complex place like Birmingham is how "Integrated" this becomes to other strategies, the emerging PA, Sport, and active travel strategies the Our future City Plan (which has no reference to PA or MH) the Green City plan, the WMCA MH commission to name but a few. How is this going to happen?

This will be led through the Health and Wellbeing Board in both places.  It is important to recognise that some plans have been published before either the local Health and Wellbeing Board Strategies or the ICS Strategy. The ICS doesn’t cover the WMCA so although their work sometimes references ICS systems it is covering a larger footprint.