At a time when the NHS is facing growing demands from an ageing population in which the burden of chronic disease is increasing, it is self evident that clinicians and organisations should work together to meet the needs of service users and ensure that the right care is provided in the right place at the right time. Just as important, there is now sufficient evidence to show the benefits of integrated care and why it should be given priority in the next stage of reform.
A new briefing from the Fund summarises this evidence and describes examples from around the world. The challenge now is how to make this happen and move beyond isolated examples of good practice.
In rising to this challenge, government must play its part by removing some of the barriers that get in the way of integration. These barriers include financial incentives that reward activity rather than continuity of care, regulation focused solely on organisations instead of systems, and a commitment to promote competition that could potentially make it harder to support collaboration where it will bring benefits.
Equally important is the need for leaders in the NHS, local government and the third sector to take the initiative and promote integrated care. In the current harsh financial climate, there is a real risk that leaders will adopt a fortress mentality in which they focus on the survival of their organisations regardless of the consequences for others. The alternative – and the one that we favour – is to take a whole system perspective and for leaders to work together across a health community to achieve financial and service targets.
The Fund is using its expertise to work with policy makers to create a context that supports integrated care. We are also providing support to NHS organisations in the North West through AQuA, as well as delivering a whole system leadership programme in five health communities in England.
The King's Fund will continue to contribute policy analysis, research and leadership development expertise to encourage and facilitate integration but neither we, nor the government, can deliver it. Making a reality of the vision of a more integrated health care system must rely on the will and commitment of local leaders to take up the challenge.
- Read Chris' latest briefing: Integrated care summary: What is it? Does it work? What does it mean for the NHS?
- Chris has also collaborated with the Nuffield Trust on their publication: Commissioning integrated care in a liberated NHS