The need to transform how community services are delivered and commissioned has never been more pressing. The population of our city is constantly expanding, leading to a huge increase in demand. Where traditional structures are in place, our health and social care system is not coping. A wealth of research has been done on the integration of community services and how this can both address financial pressure and improve health outcomes – experts have analysed and evaluated best practice and pilot schemes. When approaching the need to create a collective vision for services in the community, it was first necessary to evaluate the work done on integration to date.
- the voice of patients and carers,
- expert academic and think tank reports, and
- expert practice from both providers and commissioners.
We combined this literature review with an analysis of the Better Care Fund applications from all London boroughs – to access what was already happening and what was being planned for the future in terms of health and social care integration.
This analysis was then developed and refined by the expert views of a group of community service leaders, forming a design group to steer the project. This all resulted in our draft vision, which we are now inviting all Community Services staff in London to refine or even rewrite. Please visit our home page to view our animation and supporting document.
The research process
As the starting point to creating a collective vision for integrated services in the community, we analysed all of the Better Care Fund plans submitted by London Health and Wellbeing boards, aiming to ascertain the key themes and principles at work and the key methods outlined as being enablers of integrated working. We then evaluated key reports and findings from leading think tanks and health authorities – forming a comprehensive literature review.
Through our analysis of the vision statements and aims and objectives that open the Better Care Fund plans we found eight components that represent the most prevalent ideas that the plans incorporated. We then mapped these points onto the outputs from our literature review to come up with an eight point draft vision, which was refined further by the expertise of our design group.
- Integrated teams (Edwards, 2014) – integrated teams of health care professionals, including community services, GPs and practice staff work together with acute and social care services to help patients manage their conditions in a seamless manner.
- Joint planning (Edwards, 2014) – healthcare professionals and carers jointly agree on care and rehabilitation plans with the patient – empowering them to take control of their own care.
- Patient centred care (Department of Health, 2014) – care is centred on the patient’s needs and delivered in locations convenient for them, not designed around clinical processes or locations.
- Work proactively – care professionals work proactively to keep patients healthy and prevent further illness (Thorlby, 2013).
- Data access (Edwards, 2014) – the patient and all those that care for them, have access to their information and the technology available to attain it – this makes joined up working possible.
- Integrated leadership (Edwards, 2014) – the system shares responsibility for patient outcomes and experiences because the leaders of commissioners, primary care, local authorities, social care and voluntary sector organisations work as an integrated team.
- Pooled resources (Goodwin et al, 2013) – commissioners, in partnership with providers, are focused on outcomes and encourage integrated team work by pooling available resources.
- Talented workforce – we work together (Goodwin et al, 2013) to develop a talented workforce, proud to deliver excellent services in the community.
We now need your voice. To be representative, our vision needs to be informed by the collective expertise of staff working across London’s community services
Do you agree with this draft vision? How could we improve it?
Get involved in our online conversation now and also apply to attend or share in the outputs of our conference on July 14th 2014.
- Edwards (2014). Community Services how they can transform care, The King’s Fund, February 2014. Available at: http://www.kingsfund.org.uk/publications/community-services (accessed on 24th June 2014).
- Department of Health (2014). Transforming Primary Care safe, proactive, personalised care for those who need it most, The Department of Health, April 2014. Available at: https://www.gov.uk/government/publications/plans-to-improve-primary-care (accessed on 24th June 2014).
- Thorlby (2013). Reclaiming a population health perspective Future challenges for primary care, Nuffield Trust, April 2013. Available at: http://www.nuffieldtrust.org.uk/publications/reclaiming-population-health-perspective (accessed on 24th June 2014).
- Goodwin et al (2013). Co-ordinated care for people with complex chronic conditions Key lessons and markers for success, The King’s Fund, 2013. Available at: http://www.kingsfund.org.uk/projects/co-ordinated-care-people-complex-chronic-conditions (accessed on 24th June 2014).