Our integrated care programme of work
Many users of health and social care services experience care that is fragmented, with services reflecting professional and institutional boundaries when it should be co-ordinated around the needs of patients. These problems are most acute for people with complex health and social care needs – especially frail older people and those with long-term conditions.
Such individuals require care from multiple professionals and service providers, often delivered in different settings at different times. This can result in duplication, inefficiency, gaps in care, feelings that ‘no-one is in charge’ and ultimately poor outcomes.
Co-ordinated care is essential to help people with complex needs live healthy, fulfilling and independent lives. This means providing integrated care, with health and social care professionals working together to ensure care is co-ordinated around their needs.
Delivering integrated care for people with complex needs should be the overriding priority for the NHS over the next decade and the core business of everyone working in health and social care.
Our programme
We are launching a programme of work to promote the widespread adoption across England of effective approaches to integrated care that better meet the needs of those who stand to benefit the most, namely:
- frail older people
- people with multiple long-term chronic conditions
- people with physical and mental health problems.
We want to do this at a number of levels:
- System level – we want to influence policy so that the health care system better enables integrated care to happen.
- Programme level – we want to support organisations and care partners to design and deliver integrated care effectively in local communities.
- Clinical and service level – we want to establish how care co-ordination and the delivery of integrated services works best at a clinical and service level.
- Patient level – we want to understand better the problems faced by patients, service users, their carers and family members – so that we understand what we should measure about patient experiences that might hold the system to account.