Health and social care integration - localities: guidance

9 How Should Localities Work in Practice?

9.1 Locality arrangements must be fair, accountable, practical and proportionate. Integration Authorities, and the strategic commissioning plans they produce, must be more than the sum of the parts of locality plans. Strategic and locality level planning must work together to create the best possible working arrangements and to enable them to take account of local, and often deep rooted, issues, such as inequalities and poverty.

9.2 Localities exist to help ensure that the benefits of better integration improve health and wellbeing outcomes by providing a forum for professionals, communities and individuals to inform service redesign and improvement.

9.3 The views and priorities of localities must be taken into account in the development of the strategic commissioning plan produced by the Integration Authority. This means that localities should plan for how the Integration Authority's resources are to be spent on their local population, and the strategic commissioning plan should consolidate plans agreed in localities. For some services or care groups, it will make sense for more than one locality to work together to plan what is needed.

9.4 The starting point for the budget for locality plans will be the Integration Authority's resources that are currently used by the locality population. This historic share should be set alongside a "fair" share target, based on locality populations weighted to take account of population need and any factors relating to provision of service in the area. Local systems can obtain information on the resource use and fair share benchmarks for their localities using data available from NHS NSS^[8].

9.5 Localities must be well organised, and with sufficient structure to co-ordinate their input to strategic planning. The principle of moving away from top-down planning will only work if each locality is organised and supported to make an effective contribution. Each locality must therefore have a locality lead, who may be a GP from one of the practice clusters in the locality.

9.6 Each locality plan should include:

• A list of all the services under the management of the Integration Authority of which the locality is a part;
• A note of priorities for each locality under each of the service headings; and
• Planned expenditure under each service heading, using the locality budget described above.