System-Level Outcomes: What ICBs Actually Want Providers to Evidence
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Integrated Care Boards (ICBs) think in systems, not services. While providers often focus on service-level KPIs, commissioners are increasingly concerned with whether individual services contribute to wider system outcomes.
Providers that understand this distinction — and evidence their role within the system — are far more likely to be trusted, retained and expanded.
This connects closely with working with commissioners and regulatory alignment.
What are system-level outcomes?
System-level outcomes reflect how services contribute to:
- Reducing pressure across pathways
- Improving flow through health and care systems
- Supporting population health goals
They sit above individual service performance.
Examples of system-level outcomes
ICBs commonly look for evidence linked to:
- Reduced delayed discharges
- Stabilisation of high-intensity cohorts
- Lower unplanned admissions
- Improved cross-agency coordination
These outcomes often sit across multiple providers.
How providers contribute to system outcomes
Providers support system outcomes by:
- Preventing escalation
- Supporting timely transitions
- Sharing information effectively
- Working flexibly across boundaries
The contribution may be indirect but still critical.
Moving beyond siloed reporting
Providers often make the mistake of reporting:
- Activity without context
- Outputs instead of outcomes
- Service metrics disconnected from system pressures
ICBs expect providers to join the dots.
Using narrative to explain system impact
Because system outcomes are shared, narrative is essential. Effective providers:
- Explain their role within pathways
- Describe collaboration with partners
- Link interventions to downstream effects
This helps commissioners see value beyond contracts.
What ICBs value most
ICBs value providers who:
- Understand system priorities
- Align service delivery accordingly
- Evidence contribution honestly and proportionately
This positions providers as system partners, not just suppliers.
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