‘We need to move beyond arguing for integration to making it happen’ asserted the NHS Future Forum back in 2011. The King’s Fund and the Nuffield Trust have come together to promote the argument that ‘Integrated care is essential and can be delivered without further legislative change or structural upheaval.’

The report argues that improving integrated care should be seen as a ‘must do’ and believe it can be delivered without further legislative change or structural upheaval. They view integration as a vital development to support the ageing population and transform the provision of care to people with long-term conditions and  complex needs.  The result would be:

to make a reality of care closer to home and to reduce the inappropriate use of acute hospitals

Aim of the report

The publication is intended to provide a framework to help the Department of Health to help support the development of integrated care ‘at scale and pace’. It examines:

•  the case for integrated care
• current barriers and how to overcome these
• what the Department can do to provide a supporting framework
• options for practical and technical support to those implementing integrated care, including approaches to evaluating its impact

Setting priorities

The report identifies three priorities:

1. Setting a clear, ambitious and measurable goal to improve the experience of patients and service users

Developing integrated care for people with complex needs must assume the same priority over the next decade as reducing waiting times had during the last

 2. Offering guarantees to patients

Patients to be entitled to an agreed care plan, a named case manager responsible for co-ordinating care, and access to telehealth and telecare and a personal health budget where appropriate.

3.Implementing change “at scale and pace” 

The authors stress the need to work across large populations, to focus on people with complex needs, deploy different approaches in different areas and to use financial incentives and supporting organisational development so that NHS organisations and local authorities can develop new models of care. This calls for capacity in primary and community care and prioritise investment in social care to support rehabilitation and re-ablement plus the contribution of the independent sector and third sector organisations

 The Evidence Base

The work is informed by The Evidence Base for Integrated Care – a distillation of learning gleaned from previous research collated in 2011 by Nick Goodwin of The King’s Fund and Judith Smith from the Nuffield Trust. Published as a slide set, this looks at:

• What do we mean by integrated care?
• What problem does integrated care seek to address?
• Examples of integrated care
• Why is integrated care such a challenge?
• What can be done to support integrated care?
• What does this experience tell us about adopting and mainstreaming integrated care ‘at scale’
• How can success be defined and measured?
• Integrated care for patients and populations: improving outcomes by working together

Reference

Goodwin, N. et al Integrated care for patients and populations: Improving outcomes by working together. A report to the Department of Health and the NHS Future Forum. [PDF]   The King’s Fund and Nuffield Trust, 5 Jan 2012