Hertfordshire and West Essex had ambitions of transitioning to an Integrated Care System however they were yet to consistently work effectively as a system. CF was commissioned to support them in achieving their goal which they successfully did in May 2020.


  • Provided the roadmap to be granted ICS status which was achieved in May 2020
  • Multi-professional alignment on the approach for ICS and ICP development


In March 2018, the Hertfordshire and West Essex (HWE) STP agreed to embark upon an ambitious programme that would include transitioning to an Integrated Care System (ICS), underpinned by Integrated Care Partnerships (ICPs). HWE STP comprises of three CCGs, three acute trusts, one ambulance trust, three community and mental health trusts and two County Councils. The STP is responsible for providing health and care services for a population of 1.5m.  

HWE STP had already established some areas of excellent working, such as a nationally recognised care home Vanguard in East and North Hertfordshire, a joint health and care approach to mental illness across Hertfordshire and an emerging Accountable Care Partnership in West Essex. However, there were limited examples of working effectively as a system. 


CF was commissioned to facilitate the leadership of the STP to co-develop the scope and functions of the ICS over a twelve-week period. The piece of work culminated in alignment around a set of recommendations for HWE to accelerate progress towards being recognised as an ICS. 


The key to the success of the programme was multi-professional alignment and we, therefore, drew on a multi-professional team to deliver a varied approach:

  • Held three large workshops with Trust Chief Executives, Chief Finance Officers and Medical Directors, CCG AOs and Chairs and Local Authority Chief Executives and Chief Finance Officers. During these sessions, we helped system leaders to develop their case for change, align with the NHS England requirements, design the governance arrangements and develop ways of joint working.
  • Conducted 36 one-to-one interviews to understand the different issues that were being faced and the range of aspirations across the system
  • Issued an opinion survey to over 100 people to allow us to understand the broader landscape which we reflected back in the workshops to include the full spectrum of opinions in the design of the ICS and ICPs 


The outcome of our work with HWE was multi-professional alignment on the way forward for ICS and ICP development which ultimately contributed to HWE being granted ICS status in May 2020. CF supported this journey by delivering the following results:

  • A common case for change
  • A shared understanding of the benefits the ICS could and should achieve for the population and organisations within the system  
  • Alignment on the set of functions that the ICS will deliver 
  • Clarity on the governance of the ICS
  • Identification of the biggest barriers preventing transition to an ICS, including a set of seven recommendations to overcome them
  • Agreement on three ICPs within the ICS based around populations of adults and older people with complex needs
  • Agreement on the scope of the ICPs, the provider model to be pursued and the contracting mechanism that would support this model
  • A roadmap setting out the milestones for HWE to become an ICS