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This was the question facing CEOs of independent health CICs during a special session arranged by Social Minds and Reform. 

We were helped by six brilliant speakers: Seb Rees from think-tank Reform, Dr Aaron Gain of Warwick University, Susannah Howard of the NE Essex and Suffolk Integrated Care System,  Campbell Macdonald speaking for Social Minds and Andrew Burnell of City Healthcare Partnerships and Janet Rowse of Sirona CIC. 

The clear view from our six speakers was that smaller healthcare CIC need to grab the opportunities afforded by Integrated Care Systems.

The main reason for this is that the CICs are strongest on the big-ticket agendas where the NHS is historically weak:  preventation; early intervention, reducing health inequalities, investing in communities.

The call-to-action for CICs was that unless they are positive in forging a clear role for themselves in ICS systems, they do risk looking like an expensive add-on to a system that is increasingly working together as one.   Differentiation is key, particularly in areas that NHS Trusts don’t want to play.

All our speakers, while different in emphasis, were all essentially saying similar things: Yes the future is uncertain.  Yes the NHS is in consolidation-mode.  Yes, the sovereignty of CICs will be challenged by some of the workings of Integrated Care Organisations BUT notwithstanding all of this, there is a route to success.

This route is about about differentiation.  Being more efficient. Having stronger outcomes.  Delivering innovation.  Being great to work with and responsive to local needs.   Being the link between the formal statutory system and the voluntary and community sectors.

It was in this last areas in particular that two of our contributing organisations, Sirona CIC and City Healthcare Partnerships, have made enormous strides. 

Sirona has volunteering hubs in all of its key places across the ICS which formally link the VCS to the wider healthcare system.   Likewise, City Healthcare employs a strategy called ‘the weave’ which seeks to embed the organisation into the very fabric of the communities, they serve, adding value in so-doing and becoming a clear leader in the place-based system.

A big question was ‘ICS vs Place’?  With ICSs being so large and CICs being relatively small, it makes sense for the CICs to assert their influence at the level of Place.  Wider system-influence may happen but the capabilities of CICs, as the glue holding different parts of the system together, are most keenly felt at the level of place.

Key survival skills in the new world, where competitive tendering will largely be replaced, is being able to make your case to both NHS partners and the public.  Having a strong profile, great relationships at place level and a brilliant story of your own essential contribution locally will become more important over time.  

Overall, healthcare CICs should be an asset,not an irritation in the new world.  We can add value in distinctive ways, flex our sovereignty around new collective arrangements and complement the offering made by NHS providers, councils and the voluntary sector.   While tenders may no long be the main way we win, we can succeed through our indispensability.

To repeat Andrew Burnell:  ‘Its all in the Weave’.