Steve Field: NHS Future Forum report on integrated care

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Steve Field

Steve Field, GP and Chair of the NHS Future Forum, gives an overview of the Forum's report on integrated care.

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#968 Susan McCann
Parent/Carer

I have a son with high functioning autism, moderate learning difficulties and a complex cluster of medical conditions, including Type 1 diabetes and other endocrine problems. He is determined to live independently and has recently moved to a supported living project - the third time of trying.

The other two projects failed because care workers didn't have the knowledge to understand his medical needs; and NHS professionals are reactive and not proactive. Simply put, medicine moves on apace and many children and adults are now living much longer in our communities than previously expected but this of course impacts on whether the needs of such people can be appropriately met, and by whom and who is doing the training.

Whilst I remain my son's main carer, of course I will continue to be a part of the caring team, but as a lady in her 60s it is imperative that everyone works towards the day when I will no longer be able to do so.

At every opportunity I raise this as a major issue for my son and of course he is one of many in the community who are fine whilst the family or other carers continue to care, but if this support fails through death or ill health, the current contracted care workforce are not equipped to continue the care and NHS clinicians (District Nurse, Community Matron, Diabetes Nurse Specialists, GP, Practice Nurse) are simply reactive to need and not proactive in their support of the patient or the people contracted to work with them - and everyone tells me it is "not their budget"!!!

I recently attended an East of England NHS Personalisation event and sat next to someone who told me about hybrid careworkers who are beginning to emerge, people who span both "health and social care" who receive training to support vulnerable people in the community with conditions such as diabetes and other long term conditions.

I entirely agree that there is no time left to sit and pontificate. It is a huge culture change for NHS clinicians to accept that social care does not begin or end at the GP's front door, or the hospital's. NHS must now come on board with integrated care for people like my son so that his unmet needs can be met in the community, for day to day carers to have specialist skills as I have described and for so-called hybrid workers or any other "breed" of individual to develop skills and competencies that are needed to make the personalisation agenda for people like my son a reality and in my lifetime!

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