Integrated Care Systems have changed the way health and care organisations work together in England. For public health professionals, that matters.
Public health has always involved partnership working. Directors of Public Health, public health consultants, analysts, commissioners, health protection teams, community engagement leads and policy specialists rarely work in isolation. But the development of Integrated Care Systems has made that partnership role more formal, more visible and, in many areas, more central to local decision-making.
NHS England guidance says local public health teams should be “an integral part” of multidisciplinary work across place-based partners. It also states that Directors of Public Health have a statutory obligation to provide Integrated Care Boards with a core offer of public health advice.
For anyone working in public health, or thinking about entering the profession, this creates an important shift. Public health careers are no longer only about working within a local authority, national agency or academic setting. Increasingly, they involve working across systems.
What are Integrated Care Systems?
Integrated Care Systems, often shortened to ICSs, bring together NHS organisations, local authorities and other partners to plan and deliver joined-up health and care services for a defined area.
Each ICS includes an Integrated Care Board, which is responsible for NHS planning and funding decisions, and an Integrated Care Partnership, which brings together wider partners to shape strategy.
In practical terms, this means public health teams are expected to help the NHS and local partners understand the health needs of their population, tackle inequalities, plan prevention work and make better use of data.
That is not a small task. It requires technical expertise, political awareness, communication skills and the ability to work across organisational boundaries.
Why public health matters to Integrated Care Systems
The NHS cannot improve population health on its own. Many of the factors that shape health sit outside hospitals and GP surgeries. Housing, education, income, employment, transport, air quality, social connection and access to green space all influence health outcomes.
That is where public health brings a different lens.
Public health teams can help Integrated Care Systems ask better questions. Which communities are experiencing the worst outcomes? Where are services failing to reach people? Which interventions are likely to prevent illness rather than simply treat it later? How can local data be used to spot patterns early?
The NHS England checklist for public health in ICBs highlights several areas where public health input is needed. These include understanding the local population, using epidemiological data, learning from community intelligence, supporting joint analytical teams and ensuring health inequalities are considered in decision-making.
This makes public health expertise valuable at every stage of system planning.
The growing importance of population health intelligence
One of the clearest career implications is the growing demand for population health intelligence.
Integrated Care Systems need people who can turn data into practical insight. That includes analysts who understand health inequalities, epidemiologists who can interpret trends, and public health specialists who can explain what the data means for local services.
NHS England’s guidance specifically refers to collaborative working between public health intelligence teams and NHS analysts, with a move towards cross-system intelligence functions. It also describes joint NHS and public health analytical teams driving insight for ICB, ICP and place-based decision-making forums.
That points to a broader shift. Public health analysts are not just producing reports. They are increasingly helping shape strategy.
A good public health intelligence role may now involve working with NHS datasets, local authority data, community insight, demographic information, service utilisation data and outcomes data. The aim is not simply to describe problems. It is to help local leaders decide what to do next.
Prevention is becoming a system priority
Integrated Care Systems are also expected to think more seriously about prevention.
The NHS England checklist makes clear that prevention is not only about reducing hospital admissions. It refers to screening, immunisation, NHS Health Checks, population health management and embedding prevention in clinical pathways.
This matters for public health careers because prevention requires a wide range of roles. These may include:
- public health consultants working on prevention strategy
- screening and immunisation leads
- health improvement managers
- behavioural science specialists
- public health nurses
- commissioning managers
- programme managers for obesity, smoking, alcohol or cardiovascular disease prevention
- community engagement and health inequalities leads
For jobseekers, the important point is that prevention work may sit in different parts of the system. Some roles will be in local authorities. Others may be in NHS trusts, ICBs, charities, universities or specialist agencies.
Health inequalities are now central to system planning
Health inequalities are one of the strongest links between public health and Integrated Care Systems.
The NHS England checklist asks systems to consider the statutory duty to reduce health inequalities and to track Core20PLUS5 measures. It also refers to equity audits and the need to consider unexplained variation in access and outcomes.
This creates demand for people who can combine data, policy and community understanding.
A health inequalities role might involve identifying which groups are missing out on services, working with community organisations, designing outreach programmes or evaluating whether interventions are narrowing gaps.
These roles suit people who are comfortable working with complexity. Health inequalities rarely have a single cause and they rarely have a simple solution. The best candidates can work across data, lived experience, policy and delivery.
Public health leadership is becoming more visible
Another important shift is the visibility of public health leadership.
The NHS England checklist says ICBs should support and integrate the public health workforce, provide opportunities for public health leadership at a level of influence, and make professional public health leadership identifiable at senior ICB level.
That is significant. Public health professionals have sometimes struggled to get prevention and population health heard in systems dominated by immediate service pressures. ICS structures give public health leaders another route into strategic conversations.
For senior candidates, this means more opportunities to influence decisions across organisations. For early-career professionals, it means gaining experience in system leadership, partnership working and strategic planning may become increasingly valuable.
What skills are becoming more important?
The rise of ICS working does not remove the need for traditional public health skills. Epidemiology, health protection, health improvement, policy, evaluation and commissioning all still matter.
But some skills are becoming especially important:
System working. Public health professionals need to understand how NHS bodies, councils, voluntary organisations and communities fit together.
Data translation. It is not enough to analyse data. Public health teams need to explain what it means in a way that supports decisions.
Influencing. Much of the work involves persuading partners, shaping priorities and helping leaders think beyond short-term pressures.
Community engagement. ICSs need insight from the people they serve, not just from dashboards and formal datasets.
Health inequalities expertise. Candidates who can show experience in equity audits, Core20PLUS5, inclusion health or targeted outreach will be well placed.
Evaluation. Systems need to know whether programmes work, for whom they work and whether they provide value.
What this means for public health jobseekers
For jobseekers, Integrated Care Systems are worth understanding because they are changing the language of public health recruitment.
You may see more job adverts referring to:
- population health management
- place-based partnerships
- health inequalities
- prevention
- system leadership
- integrated care
- Core20PLUS5
- public health intelligence
- cross-sector collaboration
- community engagement
- outcomes frameworks
Candidates should be ready to show how their experience fits this system-wide agenda.
That does not mean every applicant needs direct ICS experience. Many relevant skills can come from local authority roles, NHS roles, academic research, voluntary sector work, commissioning, analytics, health improvement or community projects.
The key is to explain how your work has contributed to population health outcomes, partnership working or better use of evidence.
The opportunity for public health professionals
Integrated Care Systems are not a cure-all. Public health teams still face funding pressure, workforce shortages and the challenge of turning strategy into delivery.
But ICSs do create an opportunity. They give public health professionals a clearer route into local health and care decision-making. They also reinforce the idea that improving health is not only about treating illness. It is about prevention, equity, resilience and the wider determinants of health.
For public health professionals, that makes this an important moment. The people who can combine technical expertise with system leadership will be increasingly valuable.
Conclusion
Integrated Care Systems are reshaping public health careers by bringing public health advice, data and leadership closer to NHS planning and local system decision-making.
For jobseekers, this means opportunities in population health intelligence, prevention, health inequalities, community engagement, commissioning and senior public health leadership.
The most successful candidates will be those who can work across boundaries, use evidence well and help partners focus on long-term population health, not just immediate service demand.
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