Integrated services

The coalition government is committed to integration of services across health and social care.

According to Monitor:

  • Integrated care and support is: “Care and support is integrated when it is person-centred and coordinated”.
  • The person-centred narrative is: “I can plan my care with people who work together to understand me and my carer(s), allow me control and bring together services to achieve the outcomes important to me”.

(Complying with Monitor’s integrated care requirements, Monitor 2015)

  • Key government policies
  • Organisations
  • Keep up to date
  • Resources
  • Evidence
  • Case studies

Key government policies:

Department of Health Health and social care integration policy documents.

NHS England page on Integrated Care and Support

Complying with Monitor’s integrated care requirements, (Monitor, Jan 2015)
Read about the different models, commissioning and contracting, choice, collaboration and much more. Includes uUseful links to other documents.

A Narrative for Person-Centred Coordinated Care – what integrated care means to service users, the ‘I’ statements.

Enabling integrated care in the NHS  – Guidance from Monitor outlining how healthcare providers and commissioners can enable better integration of care so services are less fragmented and easier for patients to access. It includes:

  • A common definition for person-centred, co-ordinated care – a glossary for supporting development of integrated care
  • details of Monitors role in supporting integrated care,
  • an outline of legal obligations on NHS providers (Integrated Care Condition) and
  • tools, resources and publications.

Making sure health and social care services work together – the government policy, related actions and legislation including the Care Bill which gives local councils a duty to promote integrated services. See the Care Bill fact sheet. The Care Bill became law on 15 May 2014. Follow its progress through parliament on the Community Care website.

Integration and continuity of primary care: polyclinics and alternatives – a patient-centred analysis of how organisation constrains care co-ordination by Sheaff R, Halliday J, Ovretveit J, Byng R, Exworthy M, Peckham S, et al.. Health Serv Deliv Res 2015;3(35) Includes a comprehensive background to the policy developments around integrated services

Improving quality of life for people with long term conditions government policy and actions (2013)

Health and social care outcomes frameworks for the NHS, public health and adult social care set out the indicators for measuring outcomes within the health and social care system.

The House of Care the metaphor used by the government for high quality person-centred coordinated care.

Integrated Care: Our Shared Commitment (DH May 2013) – the government’s policy around integrated care.

Better Care Funding – The Better Care Fund (BCF) (formerly Integration Transformation Fund) is a single pooled budget to support health and social care services to work more closely together in local areas. The £3.8 billion fund was announced by the Government in the June 2013 Spending Round, to ensure a transformation in integrated health and social care.

Frequently asked questions on integrated care – Monitor September 2013
FAQs to assist commissioners, providers and health and wellbeing boards to comply with their obligations relating to integrated care, and to explain the relationship between these obligations and the other rules that Monitor enforces (including section 75 of the NHS Act 2006).

Health and care integration: making the case from a public health perspective PHE 19 December 2013
This document aims to help local areas, in particular health and wellbeing boards, make the case for integration focused on individuals’ health and wellbeing as well as their quality of life if they become sick.

Organisations:

Tools, resources and publications on integrated care – Key resources from National Voices, LGA, NHS IQ and others to support integrated care, compiled by NHS England July 2015

National Voices: bringing the voices of patients, service users and carers to bear on national health and social care policy in England. Useful collection of Commissioning resources.

Think Local Act Personal : a  national partnership transforming health and care through personalisation and community-based support.Lots of useful resources, particularly useful in relation to the Care Act.

Keep up to date:

Resources:

Integration resource library from the LGA. Definitions, FAQs, tools and resources to support the development of local integrated health and care services. Heavily bias towards social care, but increasingly useful in these days of STPs.

The Integrated Care Evaluation Framework ((ICE-F): a realistic evaluation of integrated health and social care services in Wales (Welsh Government Social Research, 2015). How the ICE-F aims to help service providers design and undertake evaluations of integrated services, specifically  the impact of delivering integrated care to older people with the aim of improving wellbeing and independence.

Commissioning for Value – Integrated Care Pathways Insights – compare your CCG/LA to similar areas for 3 new integrated care pathways: maternity and early years, dementia & long term conditions and substance misuse & mental health.

Kings Fund integrated care map – “a range of case studies to help showcase integrated care in action. “

Supporting public service transformation: cost benefit analysis guidance for local partnerships, HM Treasury April 2014. This guidance is intended for use by local partnerships in order to assess and evaluate public service transformation proposals and to better understand fiscal, economic and public benefits, and how these are apportioned across local and national organisations and communities. It includes calculations of costing of health service benefits from other service changes, and costing of benefits from health services.

North West London Integration ToolkitResources to support communities, people and partners as they work towards the shared vision of integrated care.” A step by step toolkit including resources, case studies and stories. One of the DH integration pioneers.

Integrated care value case toolkit a toolkit (from LGA, NHS England, ADASS, ADCS, Monitor, NHS Confederation and the Department of Health) including a series of value case studies, a modelling tool, tools for overcoming barriers to integrated care. The toolkit should enable Health and Wellbeing Boards and local partners to understand the evidence and impact of different integrated care models on service users, as well as the associated impact on activity and cost to different parts of the health and care system.

Integrated care – Kings Fund pages on Integrated care including an integrated care map of case studies to help showcase integrated care in action. And dont forget the Reading List –  Integrated care – commissioning and contracting. (Updated March 2014)

Integration – A key issue on the Social Care Institute for Excellence website, including case studies and resources. See also the Better Care Exchange which is a collaborative, online space for sharing learning, information and good practice on delivering better integrated health and social care, and implementing Better Care Fund plans.

Delivering integrated care and support (IRISS Insights, No 24) February 2014. This report distills key evidence to assist health and social care partnerships in Scotland in their delivery of integrated care and support under six dimensions – vision; leadership; culture; local context; integrated teams; and time.

Guides/toolkits on how to put together an integrated care pathway – Some suggested guides from the health informaticist blog (April 2009)

Evidence:

Integrated care for the frail and elderly; a review of the evidence by Susan Smith and John Gale, JET Library, Mid-Cheshire NHS Foundation Trust (with permission from John Gale).

Rapid evidence review to inform the case for change: long-term conditions and frailty by Shiona Aldridge and Alison Turner, Central Midlands Commissioning Support Unit, 2014

Searchable database of Integrated Care Initiatives on the Integrated Care and Support Exchange (ICASE) website. The site also includes case studies and evidence reports. (No longer available July 2015)

Where is the evidence for promoting integrated care? (HSJ 12 February 2014 Subscription required)
This article brings together the HSJ articles describing key integration pilots. The author concludes that “while we often hear that integrated care produces benefits for patients, a close look at the data highlights a dearth of evidence on the impact of integrated care.”

Evaluating integrated and community-based care: how do we know what works? Nuffield Trust, 2013. Evaluations of over 30 community-based interventions designed to reduce emergency hospital admissions, including POPP, DH ICP and Virtual wards. “The service models evaluated to date generally appear not to be associated with reductions in emergency hospital admissions.”

Four Nations United: Critical learning from four different systems for the successful integration of social care and health services ADASS, October 2013
This paper seeks to clarify the central contribution of social services to delivering change based on best research and practice knowledge as part of an integrated service. It aims to provide staff across key services with a ‘ready reckoner’ of best approaches to the challenge of successful integration.

Factors that promote and hinder joint and integrated working between health and social care services: A review of research literature. (Abstract) A Cameron et al, School for Policy Studies, University of Bristol, Bristol, UK. Health Soc Care Community. 2013 Jun 11. doi: 10.1111/hsc.12057.
A review of the research evidence related to joint working in the field of adult health and social care services in the UK.

Commissioning in health, education and social care: Models, research bibliography and in-depth review of joint commissioning between health and social care agencies (EPPI-Centre,University of London 2012). A systematic reviews of the research evidence on the impact of commissioning and/or reviews that consider the models of commissioning used and evidence about impacts across different sectors.

Interventions to reduce unplanned hospital admission: a series of systematic reviews. University of Bristol, June 2012. This services of reviews includes Case management,  Specialist clinics, Community interventions, Care pathways & guidelines, Medication review, Education & self-management, Exercise & rehabilitation,  Telemedicine,  Finance schemes,  Emergency department interventions, Continuity of care

Commissioning in health, education and social care: Models, research bibliography and in-depth review of joint commissioning between health and social care agencies. EPPI-Centre; Social Science Research Unit, Institute of Education, University of London, September 2012. See also the searchable database of research studies of commissioning in health, education and social welfare which is available at: http://eppi.ioe.ac.uk/webdatabases/Intro.aspx?ID=22

Integrated Care Models – an evidence search by Kieran Lamb (FADE Library). Results of a search run in April 2012, including search strategy.

Integrated Care: A Reading Lists produced by QIPP Right Care by Nicola Pearce-Smith and Sir Muir Gray, Right Care,

National Evaluation of the DH Integrated Care Pilots, RAND, March 2012
The final output of a two-year, real-time evaluation of the DH integrated care pilots (ICPs). It is intended to provide information about the evaluation activities conducted, the data collected and the analyses completed, in addition to evaluators’ conclusions about the processes and outcomes seen within the pilot period.

Getting out of hospital?  The evidence for shifting acute inpatient and day case services from hospitals into the community. This report by Health Foundation (June 2011) examines and updates the review of evidence of underpinning the policy drive to transfer acute inpatient and day-case services from hospitals into the community and the effectiveness of this to improve quality of care and save money.

Case studies

Salford Together  –  partnership is working to integrate health and social care for older people in Salford,

Knowledge Hub Health and Care Integration Group -A collection of useful reports and case studies. (You have to be registered with the Knowledge Hub to access.)

Greater Manchester Community Based Care standards – standards that outline the key outcomes which all local plans for health and social care across Greater Manchester will seek to deliver. Outcomes and metrics . Part of Healthier Together Greater Manchester.

Your care, your way (Bath and NE Somerset)The Council and NHS BaNES CCG are working together to review, design and deliver integrated community health and care services in partnership with local people. See the draft consultation document here.

Integrated Care and Support Pioneers programme –  fourteen ambitious initiatives showcasing new ways of delivering coordinated care.

Analysed: the integration of health and social care in Kent (HSJ 8 Jan 2013) Subscription required. Local Briefing looking at the Kent and Medway health economy, which is in the process of integrating its community health and social care services

Personal Care Framework – Hounslow Clinical Commissioning Group, Ealing Council and Ealing Clinical Commissioning Group
“Rather than a traditional home care Service, we seek to commission an outcomes-based Service across health and social care, which demonstrates a commitment to better quality, dignity and safety with the core aim of enabling adults, children and young people to remain in their own homes, living independently for as long as possible.” Due to start 13/08/2014.Read the tender document. 

North Norfolk Integrated Care Programme Framework Pack (N Norfolk CCG, 31/10/13)
The emerging vision includes integrated health and social care delivery teams, risk profiling, integrated care co-ordinators, identified lead workers, and an expectation that services will be delivered close to home in the community.

 

 

 


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