Published 20/04/23

Written by Dr Peter Levin


The draft Integrated Care Strategy for Cornwall & the Isles of Scilly was published at the beginning of March 2023. It is an incomplete piece of work.

  • It is described as a ‘strategy’ but offers no blueprints for action.
  • It unjustifiably treats Penwith (Penzance and its peninsula hinterland) and the Camborne/Redruth conurbation as a single ‘integrated care area’ (ICA). The two localities will have to compete for scarce resources. NHS England’s advice to consult local people about ICA boundaries has been ignored.
  • It contains many statistics and general statements that apply to the whole of Cornwall, so are of no help in deciding where to target resources.
  • It claims to be an attempt to create ‘strong, resilient and connected communities’ but turns out to be a flawed attempt at social engineering.
  • It says Cornwall has the third highest suicide rate in England and poor healthy life expectancy for men and women, but offers nothing to tackle this situation.
  • It dangles the tempting prospect of a better life for Cornwall’s young people in front of them but offers no prospect of action to realize it.
  • It fails to acknowledge that the combination of the Covid-19 pandemic, the housing shortage and the cost of living crisis is causing many Cornwall residents to be stressed, distressed and traumatized.
  • It interprets ‘engagement’ as nothing more than listening to self-selected citizens and identifying ‘general themes’, rather than conducting proper surveys and providing opportunities for the public to challenge the process.
  • Has evidently not drawn on the experience of the staff of Primary Care Networks who have considerable knowledge of local conditions.
  • It says nothing about how health and social care services will be joined up to avoid the ‘silo’ working that is so damaging and costly to the NHS and local government, although that is a major reason for integrating care systems.
  • It appears stuck in a ‘top-down’ way of thinking about strategy, when what is needed is a ‘bottom-up’ approach to health and social care today.


The full review can be found at