Integrating care: from policy to practice

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The issue

To respond to the needs of a growing and ageing population and the huge pressures facing the NHS, health and care systems need to work differently by providing more care closer to people’s homes and breaking down barriers between services. This means co-ordinating services to provide integrated care for patients, especially the growing number with multiple long-term conditions.

What did we do?

We have spent many years making the case for integrated care. Building on this work, we sought to move the debate on to population health, publishing reports that argued that NHS organisations should collaborate and work with other partners to improve the health of their local populations. Following the government’s introduction of sustainability and transformation plans (STPs) – which brought together NHS organisations and local authorities to develop plans for health and care services in their areas – our high-profile reports and national conferences analysed how the plans were being developed and implemented. We have also been at the forefront of work to develop new models of care, publishing several reports and holding numerous events to share learning.

Throughout this time, we have supported leaders to implement integrated care locally, working with them to ensure implementation is informed by evidence and good practice. In 2015, we were commissioned by NHS England to run communities of practice to support the vanguard sites developing new models of care. Building on the success of this work, we were asked to support the first wave of integrated care systems (ICSs), working closely with them as they moved from ‘shadow’ form to become fully operational in April 2018. At the same time, our Leadership and Organisational Development team has run several learning networks and been commissioned directly to support a number of local areas and organisations looking to develop integrated care.

What was the impact?

Our work to influence national policy has played an important part in the move away from competition and market-based approaches to reform towards collaboration and developing local systems of care. By the time the NHS five year forward view was published in 2014, integrated care was firmly ingrained in national policy and was central to the new care models developed in 50 ‘vanguard’ areas around the country. 

Our work shaped the development of STPs. Much of our thinking was reflected in NHS England’s update to the Forward View in March 2017, which announced the development ICSs, a practical manifestation of the approach we have advocated and supported.

Our in-depth knowledge of integrated care has fed into our work to support leaders as they seek to join up health and care services. We have worked with leaders in more than 50 places across England ­– including vanguard areas, the leading ICSs, and sustainability and transformation partnerships – to have a direct impact on implementation.

Thank you very much for facilitating the day with the Nottingham and Nottinghamshire [ICS] Leadership team…The feedback we have received has been very positive and I think it helped enormously in understanding the developing national picture, our common purpose and building trust.
David Pearson CBE, Deputy Chief Executive Nottinghamshire County Council and ICS/STP lead for Nottingham and Nottinghamshire