Delivering Integrated Healthcare Pilots

Main Category: Public Health
Article Date: 10 Jul 2008 - 0:00 PDT

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The NHS Alliance has got together with six medical speciality organisations to provide a detailed response to the announcement in the Next Stage Review of greater emphasis on integrated care and the implementation of new pilots.

Integrated Healthcare: from aspiration to implementation says there is considerable potential to improve quality at the same time as achieving significant savings. Well designed integrated care will avoid both clinical and administrative duplication. Timely and appropriate interventions will be easier to manage for patients with long term conditions and co-morbidities.

They will also be effective mechanisms for jointly commissioning, planning and delivering health and social care, and facilitate collaboration between the NHS, local authorities and other social care organisations.

There are two routes to integrated care the group says: developing clinical networks, or designing integrated care organisations (ICOs) around clusters of mature Practice Based Commissioning Groups.

The necessary building blocks are the same for both.

- Secondary care providers should be encouraged to enable specialist doctors to work in the community. Neither they, primary care trusts nor PBC groups should find they are financially disadvantaged by taking part. That will mean appropriate funding and incentives.

- Development should be clinician led with the involvement of GPs and other primary care clinicians alongside specialists - including all specialities relevant to local population needs.

- Efficient shared information systems will be vital.

- Patient participation at both collective and individual levels should be built in from the start, while annual health reviews for those with long term conditions are strongly recommended.

- A range of education, training and employment options will be necessary for sustainable success.

The paper's principal author is Dr Minoo Irani, NHS Alliance specialists' network lead and a consultant paediatrician. He said:

"It is well understood that what our patients need is seamless healthcare. Integrated care organisations are the obvious way forward to achieve that. Our group has demonstrated that clinicians are ready to work together to make it happen. Now we need the active support of local NHS management."

The group includes the Association of British Clinical Diabetologists, the British Geriatrics Society, the British Society for Rheumatology, the British Thoracic Society (GPIAG and IMPRESS), the Primary Care Cardiovascular Society, and the Society for Endocrinology alongside the NHS Alliance. They plan to continue to champion integrated healthcare by leading on several work streams:

- Patient pathways for long term conditions, with a multi-speciality emphasis. Many patients have significant co-morbidities and require input from more than one medical speciality.

- Clinical governance processes to ensure that high quality and practical measurable outcomes remain the focus of integrated services.

- Education and training programmes for the range of professionals working along integrated clinical pathways.

NHS Alliance chairman Dr Michael Dixon said;

"Our warmest congratulations and gratitude go to everyone in this group for taking forward the ideas we set out six months ago, in our discussion paper: Integrated healthcare services - the future of commissioning and provision of out of hospital healthcare in the NHS.

"Integrated care organisations will be a reality in the near future. Now we need all levels of the health service to contribute to their success."

Notes

1. The NHS Alliance is a collaboration of clinicians, managers and board members who put patients first. It is the independent body that represents NHS primary care. Values based, it is the only organisation that brings together PCTs with GP practices, clinicians with managers and Board members, and NHS primary care with its patients. The Alliance membership and its hard working national executive is fully multi-professional.

2. The Next Stage Review: our vision for primary and community care was published by the Department of Health 3rd July 2008.

NHS Alliance