Integrated Care Systems (ICSs) are central to the delivery of the NHS Long Term Plan and designed to bring together local organisations to redesign care and improve population health, creating shared leadership and action. In an ICS, NHS organisations, local authority and third sector partners such as hospices have the opportunity to ‘take collective responsibility for the management of resources to improve the health of the population they serve’.

With these strategic opportunities on the horizon the BaNES, Swindon and Wiltshire (BSW) Palliative and End of Life Care Oversight Group, a combined provider and commissioner collaborative led by the three local hospice leads (Dorothy House, Prospect and Salisbury) formed in September 2020.

Over six months the group, made up of 30 provider organisations working in partnership with ICS commissioners, co-created a new strategy for palliative and end-of-life care based on:

1. National and local policy and strategy documents.

2. Quantitative analysis of local demographic and outcome data.

3. Qualitative/lived experience feedback obtained from an ongoing survey of patients’, carers’ and families’ experiences of end-of-life care.

4. Mapping of services against items 1, 2 and 3 above.

5. An ambition to deliver services that are value for money and delivering demonstrable positive outcomes for the local populace.

The strategy is framed by eight high level recommendations which highlight how success will be measured. The first, and arguably most innovative and/or controversial recommendation, is the creation of an ICS wide, hospice led, Palliative and End of Life Care ‘Alliance’. With delegated budgetary authority this ‘Alliance’ will have accountability for ensuring equitable, outcome driven and cost efficient palliative and end-of-life care.

In June 2021 with unanimous ICS approval of the strategy, delegated transformation funds and hospice leadership, the ‘Alliance’ began meeting with an ambition to transform palliative and end-of-life care at scale across the system.