The report describes three key stages to overcoming these barriers:
- 'Living Well' pathways should inform attitudes towards care services. This demands that both housing and community-based assets are brought to the table and included in new and public debate about care. If nationally mandated and delivered at a local level, this broader approach to integration will lead to better patient outcomes.
- Developing new cultures of care. Current cultures in organisations are limiting real-time integration, so care needs to be developed together with service users with organisations realigned around shared outcomes. Collaboration across boundaries by staff needs to be incentivised and prepared for, from basic training onwards.
- Investment in new enabling technologies. Decision-makers should benchmark service planning in line with new models of support, and focus on unlocking the potential of information technologies, engagement strategies and assistive technologies across care services.
Andrew Corbett-Nolan, Chief Executive of the Good Governance Institute said: "Being able to deliver truly integrated, patient-centred care is the simplest and purest ideal in maintaining the best possible quality of life for service users. Unfortunately, failures in leadership, management and operational systems mean that care services fall short of this ideal, often at an unacceptable cost to patient safety and well-being. As one of the members of our expert group commented during the preparation of the report: 'Money follows the patient, but the patient just follows the beaten path to the hospital.'
"We need to create 'living well' pathways that integrate housing and community groups, as well as health and social care services. We need to invest in changing beliefs and behaviours, and in new technologies to create a new settlement with patients, service users and carers. Despite the apparent enormity of the challenge we face in managing future care, much can be achieved."
A recent publication from NHS England, 'The NHS belongs to the people: a call to action' also reaffirmed the need for patient-centred, preventative care for people with long-term and complex conditions. It estimated that if services continue to be delivered in the same way as now, the NHS will face a funding gap of £30bn by 2021.
The GGI's Rethinking the Integration Agenda identifies and examines the organisational and systemic obstacles to integration of services across health, housing and social care, as well as the issues in developing appropriate policies and public engagement. It also sets out innovative ideas for driving integration and creating a new paradigm of care, detailing the roles that central government, local leadership and organisations can take, together with the necessary funding and incentive mechanisms.
The report is part of a growing series promoting better governance of health and social care organisations, to improve both services and outcomes for patients. It is supported by an educational grant from Tunstall Healthcare.
The report is available from: http://good-governance.org.uk/Product%20Menus/rethinking-the-integration-agenda.htm
About Good Governance Institute
The Good Governance Institute (GGI) traces its roots back to the NHS Clinical Governance Support Team (NHS CGST) and the clinical governance movement. Now developing as an independent reference centre, GGI helps individual organisations develop their own governance and board arrangements, and promotes forward thinking and better practice nationally in governance, quality and safety.