Horizontal or Vertical: Which way to integrate?: Approaches to community services integration and consequences for emergency hospital activity: A case study based on the Transforming Community Services Policy

The Strategy Unit, Midlands and Lancashire CCG, June 2018

This report explores the impact integration choices made by Primary Care Trusts had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems. It reflects on policies that lead to structural change. In 2010-11, emphatic and definitive claims were made about the benefits of Transforming Community Services. Substantial resources were used to develop plans and extensive assurance processes were put in place to check that these would deliver the changes required. But as far as we can tell, no attempt was made to test whether the promised benefits were realised.  Eight years on from this reform and familiar claims are being made about benefits of structurally integrating services. Management teams are exploring options and developing plans and regulators are establishing new assurance frameworks. The question of whether and how to structurally integrate services lies at the heart of this process. This paper attempts to draw out the lessons from Transforming Community Services for those wrestling with this question.

Click here to view this report.

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Using Community Partnerships to Integrate Health and Social Services for High-Need, High-Cost Patients

The Commonwealth Fund, January 2018

Commonwealth Fund study that at efforts to integrate care in the United States that identifies five common challenges:

  1. inadequate strategies to sustain cost-savings, improvement, and funding;
  2. lack of accurate and timely measurement of return on investment;
  3. lack of mechanisms to share potential savings between health care and social services providers;#
  4. lack of expertise to integrate multiple data sources during health care or social services provision;
  5. lack of a cross-sector workflow evidence base.

Consensus is needed on the most appropriate payment models and ways to move away from fee-for-service.

Click here to view the report.

Rebooting health and social care integration: an agenda for more person centred care

Localis, July 2017

This report finds that the health and social care integration agenda has a future but it is dependent on moving away from notions of structural integration and reliance on central policy direction. It finds that the issue of funding and financial sustainability is critical but can only be influenced locally, not decided. The report makes recommendations for strategy and policy to support integration of health and social care.

Click here to view the full report.

Interprofessional collaboration to improve professional practice and healthcare outcomes

Cochrane Database of Systematic Reviews, June 2017

This systematic review aims to assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour).

Click here to access the review.

Mental health and new models of care: lessons from the vanguards

King’s Fund, May 2017

This report draws on recent research with vanguard sites in England, conducted in partnership with the Royal College of Psychiatrists. It finds that where new models of care have been used to remove the barriers between mental health and other parts of the health system, local professionals saw this as being highly valuable in improving care for patients and service users. It concludes that there remains much to be done to fully embed mental health into integrated care teams, primary care, urgent and emergency care pathways, and in work on population health.

Click here to view this report.

Integrated health and social care

House of Commons Committee of Public Accounts, April 2017

This report investigates the Better Care Fund and concludes that it has missed its objectives to reduce emergency admissions and delayed transfers of care. The report strongly criticises the implementation of the Better Care Fund and argues that the focus on integration should be shifted towards the STP process.

Click here to view the report.

Integration and Better Care Fund policy framework 2017 to 2019

Department of Health, April 2017

This document sets out the story of integration of health, social care and other public services, and provides an overview of related policy initiatives and legislation.

It is intended for use by those responsible for delivering the Better Care Fund at a local level (such as clinical commissioning groups, local authorities, health and wellbeing boards) and NHS England.

It includes the policy framework for the implementation of the statutory Better Care Fund in 2017 to 2019, which was first announced in the government’s Spending Review of 2013 and established in the Care Act 2014.

It also sets out the Department of Health proposals for going beyond the Fund towards further integration by 2020.

Click here to view the framework.