Integration: myth or reality for serving complex health needs across London?

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The number of people with more than one long-term condition such as diabetes, asthma or dementia is set to rise from 1.9 million in 2008 to 2.9 million in 2018. In addition, cuts in social care spending mean that more people are living with complex combinations of health and social care needs, often increasing pressures on A&E departments.

The need to deliver better joined-up care and a more sustainable NHS has never been more urgent; 14 pioneering initiatives are transforming the way health and care is being delivered to patients by integrated health and social care services and working closely with voluntary sector organisations.

The pioneers are showcasing innovative ways of creating change in the health service, which the government and national partners want to see spread across the country. The 14 ambitious initiatives are blazing a trail for change by pioneering new ways of delivering co-ordinated care. The pioneers have been selected by a renowned panel of experts, including international experts, drawing together global expertise and experience of how good joined-up care works in practice. The aim is to make health and social care services work together to provide better support at home and earlier treatment in the community to prevent people needing emergency care in hospital or care homes.

In this session we heard from Rebecca Rosen about the learning from the first year of this programme primarily in Greenwich, where she is a GP, with some additional insights from other sites in London. Rebecca spoke about the unique challenges and opportunities this programme is providing for integration in London, and shared insights about how non-executive directors can respond to the needs of their population with complex problems in the future.


Rebecca Rosen

Senior Fellow, Health Policy, Nuffield Trust

Rebecca Rosen is a Senior Fellow in Health Policy at the Nuffield Trust and a general practitioner in Greenwich. She is also an accredited public health specialist. Her current policy interests include integrated care, primary care, new organisational models for general practice and NHS commissioning.

Rebecca is a clinical commissioner in Greenwich Clinical Commissioning Group – where her lead areas are long-term conditions and primary care development.

Within her GP practice, Rebecca leads work to improve continuity and quality of care for people with chronic complex ill health and to develop integrated working across primary, community and social care services.

In the past Rebecca has worked as Medical Director of Humana Europe; as a Senior Fellow at The King’s Fund; and in NHS and academic public health departments. Past research interests include the diffusion of new medical technologies, patient choice and primary care policy.