integration across the health and social care sector richard humphries senior fellow, the king’s...
TRANSCRIPT
Integration across the health and social care sector
Richard HumphriesSenior Fellow, The King’s Fund
ADASS Spring Seminar, Warwick University, 20th April 2012
Integrated care is moving up the agenda …..
Care & Support White Paper
?
The context is tough:
Complex organisational change Different NHS/local government relationshipIntense financial & service pressuresAusterity not growth
It’s not just about adult social care.......
Local authorities & the NHS
Source: Department of Health, 2012
The organisational landscape is more complex....
So what’s the evidence ?
1. Evidence base for partnership working is weak2. Organisational integration alone will not deliver benefits3. Clinical & service integration matters most4. Focus on individual – coordination of care & support5. Clarity about purpose – what is the question to which integration is the
answer ?6. Invest time in developing relationships7. Shared local leadership is key8. No‘one-size fits all’model – doing the right things locally9. Integration will not save lots of money quickly10. Providers more likely to drive integrated care
The Mrs Smith test...
Many people with mental, physical and/or medical conditions are at risk of long hospital stays and/or commitment to long-term care in a nursing home.
Mrs. Smith is a fictitious women in her 80s with a range of long-term health and social care problems for which she needs care and support.
Mrs. Smith encounters daily difficulties and frustrations in navigating the health and social care system.
Problems include her many separate assessments, having to repeat her story to many people, delays in care due to the poor transmission of information, and bewilderment at the sheer complexity of the system.
Social Worker
Domiciliary Care
O.T.
Family & Friends
G.P.
Practice Nurse
District Nurse
O.T.
Diabetologist
Cardiologist
From a fragmented set of health and social care services …
SAP
Family and Friends
Specialist Services
Integrated Team
… to a co-ordinated service that meets her needs
Prospects: GP engagement through CCGs
More emphasis on integrated care
Health and wellbeing boards welcomed
Public health transition > welfare to wellbeing ?
? NCB/CCG balance of power eg CSUs
Structures now more complex
Instability and change threaten partnerships
Biggest challenge for NHS is productivity gap of £20b
! Massive pressure both on local government and NHS
– collaboration…. or conflict ?
http://www.kingsfund.org.uk/current_projects/health_and_wellbeing_boards_making_them_work/health_and_wellbeing.html
[email protected] @richardatkf
Some useful links -
http://www.kingsfund.org.uk/current_projects/integrated_care/integrated_care_work.html