Integrated care should be top NHS priority for the next decade say health think tanks

The King’s Fund and the Nuffield Trust have called for an ambitious new goal to be set to ensure that delivering integrated care assumes the same priority over the next decade as reducing waiting times was given over the last.

The new goal to improve the experience of patients with complex health needs is the central recommendation in a new report, Integrated care for patients and populations: Improving outcomes by working together, published by the two think tanks. The report argues that integrated care – which aims to co-ordinate care more effectively around the needs of patients - is essential to meet the needs of the ageing population and transform the way care is provided to people with long-term conditions.

The report follows the Prime Minister's pledge last year to make integrated care one of his five key priorities for the NHS and the NHS Future Forum’s call to 'move beyond arguing for integration to making it happen'. The think tanks were subsequently approached by the Department of Health to feed in ideas for a national strategy on integrated care.

This report argues that integrated care offers an opportunity to improve services for those who need them most and helps to deliver the productivity improvements on which the future of the NHS depends. It sets out a number of recommendations designed to embed integrated care across health and social care systems over the next five to ten years. These include:

  • a clear, ambitious and measurable goal to improve the experience of patients needing co-ordinated care, to be delivered by a defined date
  • enhanced patient guarantees including an entitlement to an agreed care plan and a named case manager responsible for co-ordinating care
  • reforms to financial incentives so that NHS payment systems reward good outcomes for patients rather than encouraging admissions to hospitals
  • clear guidance on how competition will operate in the NHS to avoid perceptions that competition rules are a barrier to delivering integrated care
  • a programme of organisational development to support NHS organisations and local authorities to make change happen.

The report calls on the Department of Health to articulate a clear and compelling case for change and to create an environment in which NHS organisations and local authorities can deliver integrated care at scale and pace. This, it argues, is essential to overcome a ‘permission-based’ management culture in the NHS that often discourages innovation and risk.

Chris Ham, Chief Executive of The King’s Fund, said:

'Integrated care can be delivered without further legislative change or structural upheaval and would be embraced by the professions and NHS staff. It is time to move from pockets of good practice to ensure it is a must do priority and make it the core business of everyone involved in health and social care.'

Dr Jennifer Dixon, Director of the Nuffield Trust, said:

'Let’s make integrated care real for patients, particularly older people – it is about time. The Department of Health can create an environment in which integrated care can flourish – this is less about extra spending and more about removing rigidities in the system and encouraging creativity. If not now, then when?'

Notes to editors: 

The report Integrated care for patients and populations: Improving outcomes by working together is published on 5 January 2012 by The King’s Fund and the Nuffield Trust.

To contact The King’s Fund, please ring the Press and Public Affairs team on 020 7307 2585 (if calling out of hours, please ring 07584 146035). To contact the Nuffield Trust, please ring Daniel Reynolds on 07825 510527.

In a speech on 7 June 2011, the Prime Minister said ‘integration is really important to our vision of the NHS’ and made integrated care one of his five NHS ‘guarantees’.

The NHS Future Forum published its report following the listening exercise on the Health and Social Care Bill on 13 June 2011. Follow up reports on its latest phase of engagement will be published shortly. Integrated care is one of four workstreams set up as part of this work.

A slide pack that synthesises evidence and experience about integrated care has been developed by The King’s Fund and Nuffield Trust. It covers definitions, evidence, case studies, enablers and facilitators and overall lessons and is available to download on our website: The evidence base for integrated health and social care