Integrated care: organisations, partnerships and systems Contents
Integrated care: positive examples of progress across the NHS in England
We have seen and heard of excellent examples of progress local areas have made to deliver more integrated care for patients across the country. Below are some examples from a selection of the integrated care systems, although similar examples are evident in many other parts of the country.
Frimley is one of the leading integrated care systems and one of the areas involved in the new care models programme. As part of service changes made through the vanguard programme, Frimley has achieved a decrease in hospital activity in 2017/18, despite a growth in emergency admissions in previous years. Frimley is a good example of an area that has implemented changes to bring care out of hospitals and closer to communities. For example, the area has developed urgent care hubs, run by GP practices and other services in the area, to offer same-day appointments. Patients in need of urgent medical care are seen by members of an interdisciplinary team consisting of GPs, nurse practitioners, paramedics and other relevant healthcare professionals.
Nottinghamshire provides a good example of how more integrated working between GPs, community services and care homes has helped to improve care and reduce hospital activity. Principia is one of the multispecialty community providers, consisting of a partnership between 12 local practices. which operates within the Nottingham and Nottinghamshire integrated care system. The partnership runs an enhanced GP support service in 22 care homes—including the provision of a named GP for each home—in the Rushcliffe area, which has led to a 29% reduction in A&E attendances and a 23% fall in admissions.
Buckinghamshire is an example of where local councils are working closely with the NHS to improve the health and wellbeing of the local population. There are a series of initiatives across a range of issues—such as the promotion of physical activity and health checks, prevention and early diagnosis of diabetes, falls prevention and cancer prevention—that have demonstrated significant progress, including:
- a 57% reduction in falls causing severe harm;
- a 9% increase in the uptake of NHS health checks; and
- a 17% reduction in inactivity levels and 20% increase in people achieving recommended levels of activity.
Dorset is an example of an area which is planning to make changes to its acute hospitals in order to address variations in quality and improve the financial sustainability of the system. The main hospitals in Dorset currently provide many of the same services. However, Dorset has made progress in making more efficient use of hospitals with plans to ensure each hospital specialises in a particular area. Dorset is also planning to introduce community hubs in which GPs, specialist doctors, nurses, physiotherapists and social care workers work in one place and provide more timely and effective support to rural communities within the county.
Dorset has also been using technology to help patients manage their long-term conditions. For example, patients with diabetes, chronic obstructive pulmonary disease and heart disease use mobile phone apps to manage these conditions.