Delivering integrated care: the role of the multidisciplinary team: (SCIE Highlights No 4) –

Social Care Institute for Excellence, August 2018

Report that finds multidisciplinary team (MDTs) are likely to remain an important component of health and social care. It is important that those who create, lead and work in them are aware of both the pitfalls and opportunities of MDTs. The current integrated care developments in England and internationally should provide considerable evidence about their deployment within different populations. Learning from this evidence will enable us to understand when and how MDTs should be used in the future.  Key messages are:

  • Multidisciplinary teams (MDTs) have been shown to be an effective tool to facilitate collaboration between professionals and hence improve care outcomes.
  • Successful working requires at minimum an identified manager or coordinator, regular joint meetings and the effective sharing of electronic records.
  • Teams do not necessarily have to be located in the same premises to work successfully.
  • Multidisciplinary working can be approached in more than one way as the case studies in this briefing demonstrate.
  • The success of the MDT approach is not guaranteed: without strong organisation the impact may be negative rather than positive.
  • Ongoing integrated care developments should provide further evidence to enable development of an understanding how MDTs should be used in the future.

Click here to view the full report.

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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.

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.