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Integration across the health and social care sector

ADASS Spring Seminar, Warwick University, 20 th April 2012. Integration across the health and social care sector. Richard Humphries Senior Fellow, The King ’ s Fund. Integrated care is moving up the agenda …. Care & Support White Paper ?. The context is tough:.

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Integration across the health and social care sector

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  1. ADASS Spring Seminar, Warwick University, 20th April 2012 Integration across the health and social care sector Richard Humphries Senior Fellow, The King’s Fund

  2. Integrated care is moving up the agenda ….. Care & Support White Paper ?

  3. The context is tough: • Complex organisational change • Different NHS/local government relationship • Intense financial & service pressures • Austerity not growth

  4. It’s not just about adult social care....... Local authorities & the NHS

  5. The organisational landscape is more complex.... Source: Department of Health, 2012

  6. So what’s the evidence ? • Evidence base for partnership working is weak • Organisational integration alone will not deliver benefits • Clinical & service integration matters most • Focus on individual – coordination of care & support • Clarity about purpose – what is the question to which integration is the answer ? • Invest time in developing relationships • Shared local leadership is key • No‘one-size fits all’model – doing the right things locally • Integration will not save lots of money quickly • Providers more likely to drive integrated care

  7. 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.

  8. From a fragmented set of health and social care services … Social Worker G.P. Practice Nurse Domiciliary Care District Nurse O.T. O.T. Diabetologist Family & Friends Cardiologist

  9. … to a co-ordinated service that meets her needs Integrated Team SAP Family and Friends Specialist Services

  10. 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 ?

  11. Some useful links - http://www.kingsfund.org.uk/current_projects/integrated_care/integrated_care_work.html http://www.kingsfund.org.uk/current_projects/health_and_wellbeing_boards_making_them_work/health_and_wellbeing.html R.Humphries@kingsfund.org.uk Twitter @richardatkf

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