Making integrated care happen at scale and pace

Lessons from experience
Comments: 6
The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care.

Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice.

There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice.

Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration.

Making integrated care happen at scale and pace front cover

No. of pages: 8

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#40200 Meg Kellogg
Program director
UC Berkeley

Long term interest in integration. Previously, Director of Strategic planning and analysis at kaiser permanente

#40203 Linda Hutchinson
LH Alliances

Thank you Chris and Nicola. This is an excellent, helpful summary. We all recognise that integrated care is a means to an end. As you say at the outset, that ‘end’ is to improve patient experience and outcomes and efficiency of care.

I fully support all your steps but wonder if some are relevant whether or not care is more integrated. For instance, take Step 11 Support and empower users to take more control of their health and wellbeing. One could argue that if integrated care means we effectively have an all-inclusive package holiday approach to care, will we have empowered people to be in control? Of course, if the package is determined by the patient and is bespoke to them, the answer should be yes. I believe that Step 11 is critical for improving patient experience, outcomes and efficiency in its own right and we should be doing it anyway. More integrated care should help but may be, to coin a phrase, neither necessary nor sufficient.

#40213 British taxpayer
citizen and carer

You have a strong headwind now against integrated care in the form of the Health and Social Care Act 2012 and its deliberate fragmentation of services by way of competition and markets.

#40228 Dr Alan Cleary
College Principal
Chelsea & Westminster Hospital

Arrangements should be highly localised and free of central interference. Local people have a personal interest in high standards of treatment. With strong local enforcement machinery through area medical advisers, town hall solicitors and magistrates courts(including a good proportion of retired GP's, district nurses, health visitors and the like) miscreants of all kinds will be less able to find places to hide. Town hall contracts staff, used to squeezing good value for money, are often appalled by what they hear of health service and whitehall wastage. Their professional expertise where it exists (especially in the big provincial cities) should be utilised for all health service procurement.

#40278 Jon Herries
Programme Manager - Integrated Care Collaborative
CCDHB, New Zealand

Thanks for the article. You have validated our struggles to champion a number of issues we now dealing with through our collaborative. It is heartening to know we are on the right track!

#40422 Janet Welch
Parent Carer

I agree that key is encapsulated in point 11 but I wonder if it is fully appreciated how far we are from being in a position to deliver empowerment. The process of creating personal budgets is flawed and the playing field/ market is skewed not well developed and lacks transparency which is undermining our empowerment.

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