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Integrated Care Systems Report Calls for Stability to Deliver Change
The NHS Confederation’s State of Integrated Care Systems 2024/25: Delivering Through Change report sets out a candid picture of England’s 42 ICSs under sustained strain. It finds systems are “operating under unprecedented demand, constrained resources and uncertainty about future funding and structure”, warning that the ambition to deliver joined-up, preventative and community-based care is at risk without consistent national support.
Although not a rural-specific report, many of the barriers it highlights are amplified outside cities: workforce shortages, social care fragility, longer travel times, and the need for stronger partnership with local authorities and the voluntary and community sector.
One of the most relevant examples in the report comes from Devon ICS, which is using digital tools to improve access and coordination across a geographically large and diverse system. The review notes how Devon has invested in shared digital infrastructure to connect data between primary, community and acute services, enabling clinicians to access real-time information and helping to manage demand across dispersed populations.
The report highlights this as evidence of how “place-based and digitally enabled collaboration can deliver better outcomes even where geography poses challenges.”
Read more and download the report here
Rural Research Snapshot: Evidence Behind the HeadlinesWhile the State of Integrated Care Systems 2024/25 report is national in scope, its findings resonate strongly with issues long recognised in rural policy and service delivery. RSN’s Delivering for All roadmap emphasises that effective national reform depends on recognising the distinctive needs of rural places, from workforce planning and transport to health and care provision. It calls for a dedicated rural workforce strategy and for all policy to be Rural Proofed, ensuring proposals to reduce health inequalities take account of “the whole range of extra costs of delivering services in rural areas.” The roadmap also highlights how access to good quality jobs, housing and services is fundamental to reducing the wellbeing gap between rural and urban areas. These priorities are supported by new evidence from Rural England CIC’s State of Rural Services 2025 report, which sets out a detailed picture of service access across rural England. It finds that:
Taken together, these findings underline why place-based flexibility, data sharing and digital inclusion are vital to the success of integrated care reforms. They demonstrate that integration will only work if it recognises how geography, distance and demography shape service access, and if the right support is in place for systems serving large and dispersed rural populations. As Delivering for All concludes, meaningful change depends on ensuring that “change reaches every community, including those in rural areas.” |
