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Inclusion health at scale: beyond pockets of excellence

The King’s Fund is working in a new partnership with Pathway and with Groundswell to build a community of leadership practice across seven integrated care systems to explore how to develop consistently good services to each group within the inclusion health population and how to scale up good practice examples to achieve system-wide success.

Why we're doing this project

Inclusion health covers a number of traditionally excluded populations, including:

  • people currently experiencing homelessness or at risk of homelessness

  • forced migrants and refugees

  • Roma and traveller communities

  • those with substance and alcohol misuse difficulties

  • people involved with the criminal justice system including prisons

  • sex workers.

Clinical outcomes among these groups are among the worst nationally. Changing these outcomes is one of four strategic priorities for The King’s Fund. Our review to identify how we would do this identified inclusion health as a focus for our work.

With the publication of NICE-approved guidance on homelessness and practical steps taken during the Covid-19 pandemic there is plenty of evidence of what works to do improve outcomes for these groups. The challenge is applying that evidence, but the statutory launch of 42 new integrated care systems (ICSs) in July 2022 provides a new opportunity to convert intention into action.

What we're doing

The King’s Fund is working in a new partnership with Pathway and with Groundswell. Pathway supports a faculty of inclusion health practitioners, linked to University College, London. Groundswell is a delivery organisation supporting local systems with care solutions and health needs analysis, grounded in the lived experiences of clients. The King’s Fund has collaborated with these organisations previously, including through the GSK Impact Awards. These partner organisations offer deep experience of the sector of inclusive health, and in particular a commitment to co-production and client participation.

Together, we are running a unique shared learning programme between September 2022 and April 2023. That shared programme draws on insights and experiential lessons from 7 of the 42 ICSs in England. The 7 sites have been selected after a competitive process and all are committed to understanding current practice in inclusion health from across England. We want to build a community of leadership practice to deliver excellence to each group within the inclusion health population, and to do so at scale across their systems. We are exploring two key areas in particular:

  • how to develop consistently good services across the whole inclusion health cohort

  • how to scale up from examples of good practice in a given neighbourhood to achieve system wide success.

The 7 integrated care systems taking part in this work are:

Though the primary purpose of our work is to offer insights for the benefit of participants, we will seek to share findings along the way exploring the challenges of service improvement for marginalised groups and examples of outstanding success.

The programme is committed to co-production and the participation of those with lived experience at every stage of our work.

Key milestones

Work starts in September 2022. A blog explaining the purpose of our work has been published by The King’s Fund. Partners presented key findings from our work at the annual Pathway conference in 2023. Material highlighting thematic lessons and examples of good practice was shared during the six months of the programme.