Accountable Care Organisations (ACO), Accountable Care Systems (ACS) and Integrated Care Systems (ICS)
The origins of the idea
The Health and Social Care Act 2012 ordered a split between those commissioning health services and those delivering them. The current Secretary of State for Health and Social Care, Jeremy Hunt, has admitted that this was not a successful change: ‘when you’re dealing with complex patients who are going in and out of the system a lot those structures prove not to be fit for purpose’ (Lintern, 2017).
The creation of STPs (either Sustainability and Transformation Plans or Sustainability and Transformation Partnerships, depending) saw the pendulum swinging back from the 2012 act. England was divided into 44 footprints, within which providers and commissioners – including councillors – were asked to work together to address the challenge set out by the NHS Five Year Forward View. This pendulum swing continues with the UK’s government’s interest in the type of organisations which are variously known as Accountable Care Organisations (ACO), Accountable Care Systems (ACS) and Integrated Care Systems (ICS). According to NHS England, ‘An ACS will be an ‘evolved’ version of an STP that is working as a locally integrated health system.’ (NHS England, 2017)