Delivering the Joint Forward Plan and future development.
In 2024/25, the NHS Devon Integrated Care Board (ICB), with the agreement of its NHS system partners, established new governance and assurance structures for the One Devon Integrated Care System.
NHS Devon
The NHS Devon Board is accountable for approving and delivering the ICB’s actions associated with the improvement plan agreed with NHS England. It also has a role in relation to providing strategic leadership for the system-wide recovery process, by facilitating whole-system approaches to service and financial sustainability.
Assurance to the NHS Devon Board with regard to system recovery-related activity has been provided through Quality and Patient Experience Committee, and Finance and Performance Committee, both of which are chaired by an Independent Non-Executive Member of the Board.
One Devon System Leadership Group (SLG)
The One Devon Leadership Delivery Group (SLG) acts as the key group for the co-ordination of decision-making across the One Devon ICS. It is chaired by the NHS Devon Chief Executive Officer and through it the NHS partners in the One Devon ICS work together to ensure the delivery of system recovery, the Joint Forward Plan and other agreed system priorities, as well as informing in-year priorities.
The SLG ensures that key system decisions are agreed in principle before being disseminated to One Devon ICS NHS partner organisations for formal approval (if necessary – many of the decisions of the SLG will relate to high level operational issues that fall within the delegated authority of its members). In 2025/26, the focus of the SLG will be on delivery of the plans agreed by members’ Boards.
Transformation
A major development this year has been the launch of our Transforming Devon Programme—a multi-year, complex, system-wide change programme spanning four strategic pillars.
Transforming Devon will serve as the vehicle for supporting system recovery from NOF4 while also driving the longer-term transformational work outlined in our JFP. The programme’s initial focus areas are:
- Clinical Service Change
- System Productivity and Efficiency
- Integrated Clinical Support Services
- Shared Non-Clinical Support Services
Agreement has already been reached to progress each of these pillars through a system-wide Transforming Devon programme. The programme will not only enable us to take forward the strategic opportunities set out in the MTFP, it also enables us to develop the system governance and delivery architecture to drive broader system-level transformations, such as those described in our JFP.
Over time, the infrastructure and capability the Transforming Devon Programme will be further developed and strengthened to support the system’s long-term journey toward clinical and workforce sustainability.
Transformation Oversight Group (TOG)
The Transformation Oversight Group (TOG) is the forum through which delivery of system-wide transformation programmes is driven, managing interdependencies, ensuring alignment of outcomes and unblocking tactical delivery issues.
The scope of the TOG encompasses the workstreams identified as part of the Transforming Devon Programme; however, it is designed to also cater for any programme across the One Devon Integrated Care System that delivers across multiple organisations or is complex due to its interdependencies across the system.
Programmes being driven through the TOG may be initially conceived elsewhere (Provider Collaboratives, SLG, NHS Devon etc.), with SLG commissioning and agreeing those programmes that are driven through TOG and any changes in scope.
The TOG will not act as the formal decision making forum for programmes, but will provide a forum for jointly agreed recommendations to be made in regards to the optimal delivery and alignment of programmes, which will ultimately allow organisational boards to take sovereign decisions.
The TOG will enable a standardised approach to reviewing progress of system wide programmes of work, and will be the forum for agreeing the standard Transformation and Programmatic approach to be taken across the One Devon Integrated Care System.
Planning and Delivery Meetings supporting the SLG
Three Locality Planning and Delivery Meetings (LDPMs) have been established, reporting into the SLG, as follows:
- Northern and Eastern Locality Planning and Delivery Meeting
- West Locality Planning and Delivery Meeting
- South Locality Planning and Delivery Meeting
Alongside these meetings, a Mental Health Planning and Delivery Meeting has also been set up, which works on a system-wide basis.
Chaired by the NHS Devon Chief Executive Officer, each planning and delivery meeting is attended by relevant NHS Devon Chief Officers and Locality Leads, as well as the Executive Team of the relevant NHS provider. In 2025/26 Primary and Community Care representatives, Local Authority colleagues, other key stakeholders and relevant NHSE colleagues (South West Regional Team/National RSP Team/other National Teams as appropriate) will also be invited to join these meetings.
Each of these meeting follows a standard agreed agenda and data and to enable specific scrutiny of performance including but not limited to; RTT, Cancer, Diagnostics, Urgent Care including ambulance handover, out of hospital services, ERF activity, Quality issues and any further metrics related to NOF (not just those areas in Segment 4). This process would recognise the accountability of individual providers in achieving performance, explore the support that they require from NHS Devon and be focussed on future improvements against agreed performance standards, including rigorous review of trajectories and action plans for areas of performance not meeting agreed standards.
An aggregated dashboard and highlight report of the issues discussed by each meeting is submitted to the One Devon SLG and the NHS Devon Executive, in advance of its submission to the NHS Devon Finance and Performance and Quality and Patient Experience Committees, as appropriate, and the NHS Devon Board. This report is also be shared with the System Integrated Assurance Group (SIAG). This enables the SIAG to take assurance of the steps being taken to address the overarching actions required to meet the system’s NOF4 exit criteria, as well as the actions required to address each individual provider’s NOF segmentation.
In due course, each Locality (all constituent partners including NHS Trusts) will be expected to develop Delivery Plans in response to the One Devon Integrated Care System Operational Plan. The LPDM will then become the place where all partners are then required to demonstrate progress against these plans and course correct as necessary. Work will begin on this as soon as possible.
System co-ordination – working more closely with the provider collaboratives
To ensure the work of the existing Provider Collaboratives reflects support the delivery of the key system priorities dedicated Provider Collaborative Engagement Meetings (PCEMs) are being established with each as follows:
- Peninsula Acute Provider Collaborative Engagement Meeting
- Mental Health Learning Disability and Neurodiversity Provider Collaborative Engagement Meeting
- Primary Care Provider Collaborative Engagement Meeting
Each of the Provider Collaboratives within the One Devon Integrated Care System is at a different level of maturity. Chaired by the NHS Devon Chief Executive Officer, the expectation is each PCEM would be attended by all relevant NHS Devon Chief Officers and the leadership of the relevant Provider Collaborative.
The detail of the business conducted at each of these meetings will be worked through collaboratively over the course of the next few months. It is envisaged that it will focus on:
- Longer term projects and strategy development
- Specific pieces of work that can only be delivered through working in partnership
- Ensuring clear plans in place to address fragile services
- Reviewing challenges in-year
The outcomes of these meetings will be presented to the SLG.
As the meetings should be co-designed with the Provider Collaboratives, it is likely that they will differ in focus and scale, with some taking place at Locality level, whilst others may look to whole peninsula working and require engagement with NHS Cornwall and the Isles of Scilly Integrated Care Board.
System Integrated Assurance Group (SIAG)
The System Integrated Assurance Group (SIAG) is an assurance meeting that was established by NHS England to oversee the progress being made by NHS system partners within the One Devon ICS towards NOF4 exit.
Due to NHS Devon’s NOF4 status and the identified gap in performance management and oversight, NHSE’s South West Regional and National Teams have assumed this role in an attempt to gain further assurance particularly focussing on elective long waiters and urgent care.
One Devon Integrated Care Partnership
The One Devon Integrated Care Partnership (ICP) is a joint committee established by NHS Devon and its Local Authority partners which includes a range of organisations and groups who can influence people’s health, wellbeing and care. Its primary aim is driving integration by producing a strategy to join-up services, reduce inequalities, and improve people’s wellbeing, outcomes and experiences.
All partners are jointly accountable for delivering this strategy by:
- Facilitating joint action to improve people’s health and care, and reduce inequalities
- Influencing wider factors that affect health (like housing) to create healthier environments
- Building a culture of collaboration to promote and support wellbeing, and involve people
Work has been undertaken to refresh the One Devon ICP in 2024/25 and a new Chair has recently been appointed. This committee will focus on the review of the integrated care strategy and neighbourhood health in 2025/26.
Accountability
The One Devon ICP has overall accountability for the vision, aims and strategic goals contained in in One Devon’s Integrated Care Strategy. NHS Devon, local authorities and NHS provider organisations are accountable for the delivery of key plans described in this overarching Joint Forward Plan which is designed to implement the strategy.
ICS outcomes framework
The Integrated Care System Outcomes Framework is an interactive dashboard designed to track progress against the strategic goals set out in the One Devon Integrated Care Strategy.
Aligned with national frameworks such as NHS Outcomes, the Public Health Outcomes Framework, and the Social Care Outcomes Framework, it focuses on quantitative measures to provide a clear, data-driven view of system performance with a focus on understanding the impact of our work over the medium and longer term.
The framework enables us to demonstrate progress over time, evaluating whether our strategic priorities are being delivered and whether our work is achieving the desired outcomes for Devon’s population.
It is a valuable tool for the One Devon Integrated Care Partnership, our System Leadership Group, and other relevant groups and bodies, supporting assurance, evidence-based planning and continuous improvement.
The framework is available via an interactive dashboard with drill down functionality to highlight inequalities and support local action.
The dashboard provides breakdowns of information at three ICS tiers (system, LCP and PCN), two local authority tiers and for inequalities (socio-economic, geographic, personal characteristics and clinical factors). The ICS outcome measures and key indicators are shown below.
| ICS Outcome Framework Measures | ||
| Admissions Following Accidental Fall | Support from local organisations to manage own condition | Population vaccination coverage (5 years old) |
| Deaths in usual place of residence | Digital exclusion risk index (DERI) | Flu vaccination coverage (at risk individuals) |
| Total Carbon Emissions (kt CO2) | Unified Digital Infrastructure | Covid-19 vaccination rates |
| NHS and LA Attributable Carbon Emissions (kt CO2) | Healthy Life Expectancy at birth | Children and young people accessing mental health services |
| Deaths attributable to air pollution | Gap in Healthy Life Expectancy at birth | Coverage of 24/7 crisis support for mental health |
| Index of Multiple Deprivation | Under 75 mortality rate from causes considered preventable | Suicide Rate |
| Access to Community Facilities | Global Burden of Disease: Top 10 Causes (DALYs) | Placeholder: Social Prescribing Uptake Rates |
| Rough sleepers per 1,000 households | Global Burden of Disease: Top 10 Modifiable Risk Factors (DALYs) | Access to eating disorders services for CYP |
| Average house price to full time salary ratio | Children achieving a good level of development at the end of Reception | Avoidable admissions for ambulatory care-sensitive conditions |
| Households in temporary accommodation | 16-17 year olds not in education, employment or training (NEET) | Patient Activation Measures |
| Supply of key worker housing | Employment of people with mental illness or learning disability | Access to dentists / pharmacy / optometry / primary care |
| Fuel poverty | Workforce diversity (employment profile vs Devon by EDI characteristics) | Vacancy Rate for ICS Organisations |
| One Devon Cost of Living Index | Uptake/Coverage of Local Authority Carer Support Services | Financial Sustainability |
| Investment in Local Communities and Businesses | Unpaid Carers Quality of Life | Unified Approach to Procurement and Commissioning |
| Improved experience of navigating services | Carers Social Connectedness | Community Empowerment / Volunteering |
| Waiting Times | ||
