Acute hospitals and integrated care: From hospitals to health systems – King’s Fund – 19 March 2015

Posted on March 20, 2015. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , |

Acute hospitals and integrated care: From hospitals to health systems – King’s Fund – 19 March 2015

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Population health systems: Going beyond integrated care – King’s Fund – 23 February 2015

Posted on February 25, 2015. Filed under: Public Hlth & Hlth Promotion | Tags: , |

Population health systems: Going beyond integrated care – King’s Fund – 23 February 2015

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The Antidote to Fragmented Health Care – Harvard Business Review – 15 December 2014

Posted on December 17, 2014. Filed under: Health Systems Improvement | Tags: |

The Antidote to Fragmented Health Care – Harvard Business Review – 15 December 2014

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Capitation: a potential new payment model to enable integrated care – NHS England – 26 November 2014

Posted on December 10, 2014. Filed under: Health Economics | Tags: |

Capitation: a potential new payment model to enable integrated care – NHS England – 26 November 2014

Extract

“Across the health services sector, there is a move towards offering more integrated care, especially for patients who have multiple long term conditions and need care
from many providers across different care settings. The launch of the ‘Five Year Forward View’1 and the Integrated Personal Commissioning (IPC) programme have added impetus to this trend. However, sector feedback indicates that the current forms of payment does not always support the delivery of more person centred co-ordinated care.

Monitor and NHS England are committed to using the full potential of the payment system to provide better support across the country for innovations in patient centred, co-ordinated care. To enable such innovation, the Health and Social Care Act 2012 provides for payment arrangements to be determined locally rather than nationally,
2 where this will benefit patients.

Capitated payments are one such payment arrangement that several local care economies are developing. Broadly speaking, capitated payment or capitation means paying a provider or group of providers to cover the majority (or all) of the care provided to a target population, such as patients with multiple long term conditions (LTCs), across different care settings. The regular payments are calculated as a lump sum per patient. If a provider meets the specified needs of the target population for less than the capitated payment, they will generate a financial gain to the local health system. Allowing providers to share in any such gain gives them an added incentive to keep patients in their target population healthy. They are more likely to identify risks, intervene early and arrange the right treatment for patients, at the right place and the right time to aid patients’ recovery, continued wellness and better management of long term conditions.”

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What is the evidence on the economic impacts of integrated care? – Integrated Care Summit – The King’s Fund, 14 October 2014

Posted on October 29, 2014. Filed under: Health Systems Improvement | Tags: , |

What is the evidence on the economic impacts of integrated care? – Integrated Care Summit – The King’s Fund, 14 October 2014

Ellen Nolte, Emma Pitchforth

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System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities – The King’s Fund – 14 October 2014

Posted on October 20, 2014. Filed under: Health Mgmt Policy Planning | Tags: , |

System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities – The King’s Fund – 14 October 2014

“A consensus is emerging in England around the concept of ‘integrated care’ as the best hope for a sustainable NHS. For leaders in the health care system, this represents an immense challenge. Leading across complex interdependent systems of care is a new and different role, undertaken alongside the already difficult task of leading successful institutions.
This paper seeks to identify the skills, knowledge and behaviours required of new system leaders and to learn from systems attempting to combine strong organisational leadership with collaborative system-level leadership approaches. The paper draws on three years’ development work with leaders in health care systems in north-west England, undertaken by the Advancing Quality Alliance (AQuA) and The King’s Fund which has adopted a ‘discovery’ approach to developing integrated care and the leadership capabilities supporting it.”

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No Assumptions – A Narrative for Personalised, Coordinated Care and Support in Mental Health – Centre for Workforce Intelligence (CfWI) [UK] – 29 August 2014

Posted on September 2, 2014. Filed under: Mental Health Psychi Psychol | Tags: |

No Assumptions – A Narrative for Personalised, Coordinated Care and Support in Mental Health – Centre for Workforce Intelligence (CfWI) [UK] – 29 August 2014

“No Assumptions: A Narrative for personalised, coordinated care and support in mental health is a resource to help NHS, council commissioners and providers of services organise person-centred care based on what people with live experience of mental illness say is important to them.

The resource was co-produced by TLAP and National Voices with people with mental health needs from TLAP’s National Co-production Advisory Group, the National Survivor User Network, Mind, Rethink Mental Illness and Certitude.”

News release: Think Local Act Personal launches new mental health resource Think Local Act Personal launches new mental health resource

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Caring for High-Need, High-Cost Patients: What Makes for a Successful Care Management Program? Issue Brief – The Commonwealth Fund – 7 August 2014

Posted on August 8, 2014. Filed under: Chronic Disease Mgmt | Tags: , , |

Caring for High-Need, High-Cost Patients: What Makes for a Successful Care Management Program? Issue Brief – The Commonwealth Fund – 7 August 2014

“Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target “high-need, high-cost” patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management. We found that effective programs customize their approach to their local contexts and caseloads; use a combination of qualitative and quantitative methods to identify patients; consider care coordination one of their key roles; focus on building trusting relationships with patients as well as their primary care providers; match team composition and interventions to patient needs; offer specialized training for team members; and use technology to bolster their efforts.”

Toward Increased Adoption of Complex Care Management – NEJM – 7 August 2014

Instant Replay – A Quarterback’s View of Care Coordination – NEJM – 7 August 2014

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The Principles of Workforce Integration – Skills for Care – 17 July 2014

Posted on July 22, 2014. Filed under: Workforce | Tags: , , , |

The Principles of Workforce Integration – Skills for Care – 17 July 2014

CfWI contributes to newly launched principles of workforce integration – CfWI Centre for Workforce Intelligence – 17 July 2014

“Skills for Care have launched new ‘Principles of Workforce Integration’ at the Local Government Association conference, designed to help care professionals to work together to meet people’s care and support needs.

Underpinning the six core principles is the idea that people who have care and support needs want care provided in straightforward ways that makes sense to them, reflecting their lives, needs and wishes.

The principles have been developed to support practitioners, managers and organisations to think about what integration means for their organisation and how effective workforce development can drive its implementation.”

… continues on the site

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What is the evidence on the economic impacts of integrated care? – European Observatory on Health Systems and Policies (EOHSP) – 6 June 2014

Posted on June 10, 2014. Filed under: Health Economics | Tags: , , , |

What is the evidence on the economic impacts of integrated care? – European Observatory on Health Systems and Policies (EOHSP) – 6 June 2014

News release: What is the evidence on the economic impacts of integrated care?

“This new policy summary reviews the existing evidence on the economic impact of integrated care approaches. Whereas it is generally accepted that integrated care models have a positive effect on the quality of care, health outcomes and patient satisfaction, it is less clear how cost effective they are. As the evidence-base in this field is rather weak, the authors suggest that we may have to revisit our understanding of the concept and our expectations in terms of its assessment.

Integrated care should rather be seen as a complex strategy to innovate and implement long-lasting change in the way services in the health and social-care sectors are delivered.

This policy summary (number 11) is based on a report for the European Commission to inform the discussions of the EU’s Reflection process on modern, responsive and sustainable health systems on the objective of integrated care models and better hospital management. Both authors are affiliated to RAND Europe.”

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Patient and Family-Centred Care: practical tools to improve patient experience – King’s Fund – 4 June 2014

Posted on June 5, 2014. Filed under: Patient Participation | Tags: , |

Patient and Family-Centred Care: practical tools to improve patient experience – King’s Fund – 4 June 2014

Details

Blog entry

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Behavioral Health Integration Capacity Assessment Tool – Institute for Healthcare Improvement – 2014

Posted on May 30, 2014. Filed under: Health Mgmt Policy Planning | Tags: , , , , |

Behavioral Health Integration Capacity Assessment Tool – Institute for Healthcare Improvement IHI – 2014

“The purpose of the Behavioral Health Integration Capacity Assessment (BHICA) is to assist behavioral health organizations in evaluating their ability to implement integrated care. The BHICA enables behavioral health organizations to evaluate their processes related to three approaches to integrated care: coordinate care, co-locate care, or build primary care capacity in-house. It also allows organizations to assess their existing operational and cultural infrastructure to support greater integration. The BHICA was developed by IHI and the Lewin Group under a contract from the CMS Medicare-Medicaid Coordination Office.”

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Focus On: Social care for older people. Reductions in adult social services for older people in England – Quality Watch – March 2014

Posted on April 4, 2014. Filed under: Aged Care / Geriatrics | Tags: , , |

Focus On: Social care for older people. Reductions in adult social services for older people in England – Quality Watch

“Budget allocations from central Government to English local authorities were reduced by 14% in real terms between 2011/12 and 2014/15. This report asks how local authorities have responded to this decline in income and explores the possible impact on older adults’ health and wellbeing.”

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A new settlement for health and social care: interim report – King’s Fund – 3 April 2014

Posted on April 4, 2014. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , , |

A new settlement for health and social care: interim report – King’s Fund – 3 April 2014

“This is the interim report from the independent Commission on the Future of Health and Social Care in England. In it, the commission explains why it believes England needs a single health and social care system, with a ring-fenced, singly commissioned budget, and more closely aligned entitlements. Drawing on accounts from patients and their families, the commission argues that the current system is no longer fit for purpose.

At the root of the problem is a lack of alignment in funding, organisation and entitlement. The report analyses the historical divides between the two systems, the effects of our ageing society, and issues of affordability, before exploring options for change in meeting the costs ahead. It concludes with a call for responses to these options.”

… continues on the site

 

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Accountable care organisations in the United States and England: Testing, evaluating and learning what works – King’s Fund – 27 March 2014

Posted on March 28, 2014. Filed under: Chronic Disease Mgmt | Tags: , |

Accountable care organisations in the United States and England: Testing, evaluating and learning what works – King’s Fund – 27 March 2014

“The health system in England is facing a number of challenges including an ageing population, an increasing number of people with multiple, long-term conditions and a difficult financial climate. To meet these challenges, more integrated approaches to care delivery are needed to improve both the quality of care and patients’ experience.

More people now need care across a number of different settings – hospitals, primary care, clinics, nursing homes and home care agencies – which are not co-ordinated, resulting in duplication of cost and effort and gaps in information and communication. In the United States, accountable care organisations (ACOs) – a group of providers that take responsibility for providing all the care for a given population for a specified period of time – have been developed to provide a more integrated approach to care.

Accountable care organisations in the United States and England describes the different types of ACOs emerging in the United States; presents some early evidence on their performance; assesses the future for ACOs; and discusses the implication of these developments for integrated care initiatives in England.”

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Coalition for Collaborative Care – UK

Posted on March 25, 2014. Filed under: Chronic Disease Mgmt | Tags: |

Coalition for Collaborative Care – UK

“The Coalition for Collaborative Care is a group of individuals and organisations across the health, social care and voluntary sectors who want to make person-centred, coordinated care a reality for people living with long-term conditions. That means improving the relationship that people have in their day-to-day interaction with the NHS and social care so their care and support is organised around what matters to them.

We are doing this through the House of Care. The House of Care was developed and tested by the Year of Care programme and People Powered Health. It is a flexible blueprint that uses collaborative care and support planning and at the same time recognises the importance of non-medical, community-based activities and resources. This ‘more than medicine’ approach helps each person develop the knowledge, skills and confidence to manage their condition/s within a supportive community.”

.. continues on the site

Current members:
Royal College of General Practitioners | Year of Care Partnerships | Nesta | National Voices | NHS England | NHS IQ | The Health Foundation | Diabetes UK | British Heart Foundation | ADASS | College of Social Work | more members coming soon…

 

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The Importance of Multimorbidity in Explaining Utilisation and Costs Across Health and Social Care Settings: Evidence from South Somerset’s Symphony Project – University of York, Centre for Health Economics – February 2014

Posted on March 12, 2014. Filed under: Chronic Disease Mgmt, Health Economics | Tags: , |

The Importance of Multimorbidity in Explaining Utilisation and Costs Across Health and Social Care Settings: Evidence from South Somerset’s Symphony Project – University of York, Centre for Health Economics – February 2014

Abstract

Aims
Since the inception of the NHS, an ever-present challenge has been to improve integration of care within the health care system and with social care. Many people have complex and ongoing care needs and require support from multiple agencies and various professionals. But care is often fragmented and uncoordinated, with no one agency taking overall responsibility, so it is often left to individuals and their families to negotiate the system as best they can. South Somerset’s Symphony is designed to establish greater collaboration between primary, community, acute and social care, particularly for people with complex conditions.

Methods
We examine patterns of health and social care utilisation and costs for the local population to identify which groups of people would most benefit from better integrated care. We analyse data to identify groups of people according to the frequency of occurrence of underlying conditions; the cost of care; and utilisation of services across diverse settings. The empirical identification strategy is supplemented by local intelligence gained through workshops with health and social care professionals about the appropriateness of existing patterns of provision. We employ two-part regression models to explain variability in individual health and social costs, in total and in each setting.

Data
The Symphony Project has an anonymised individual-level dataset, spanning primary, community, acute, mental health and social care. This includes activity, costs, clinical conditions, age, sex and ward of residence for the entire population of 114,874 people in 2012. Each person’s morbidity profile is described using the United Health’s Episode Treatment Groups (ETG), which build upon ICD and Read codes.

Results
We identify the frequency of conditions and co-morbidity profile of the entire population and, for the most frequent conditions, we assess utilization and costs of care across health and social care settings. For example, for those with asthma and diabetes, hospital costs account for the largest proportion of costs; in contrast, costs for those with dementia occur mostly in social care, mental health care and community care settings. For the population as a whole, we find that costs of health and social care are driven more by an individual’s morbidity profile than by their age. Data for those with the most frequent conditions were reviewed by local health and social care professionals and managers. It was decided to undertake more detailed analyses for those with diabetes or dementia. 5,676 people are recorded as having diabetes in South Somerset, with hypertension being the most common comorbidity. For those with a sole diagnosis of diabetes, costs are around £1,000 on average but as people are recorded as having more diagnoses, average costs increase progressively. Costs are also higher for older people and women.People with dementia account for only 0.92% of the South Somerset population, but the average annual cost for the 1,062 people with dementia is around £12,000. A high proportion of these costs are related to the provision of mental health, social and continuing care. Costs are higher the more co-morbidities a person has, and for people from more deprived areas. Age and gender do not explain variation in costs for people with dementia.

Conclusions
This work forms a basis for identifying groups that would most benefit from improved integrated care, which might be facilitated by integrated financial arrangements and better pathway management. The more co-morbidities that a person has, the more likely they are to require care across diverse settings, and the higher their costs. Our analysis identifies those groups of the population which are the highest users of services by activity and cost and provides baseline information to allow budgetary arrangements to be developed for these targeted groups.

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Making our health and care systems fit for an ageing population – The King’s Fund – 6 March 2014

Posted on March 7, 2014. Filed under: Aged Care / Geriatrics, Health Systems Improvement | Tags: , , |

Making our health and care systems fit for an ageing population – The King’s Fund – 6 March 2014

“Our fragmented health and care system is not meeting the needs of older people, who are most likely to suffer problems with co-ordination of care and delays in transitions between services. This report sets out a framework and tools to help local service leaders improve the care they provide for older people across nine key components.”

A year is a long time in the politics of integrated care – blog entry on the King’s Fund site – 5 March 2014

John Oldham to lead Labour ‘commission’ on integration – 23 April 2013

“Labour will set up an independent commission to examine how health and social care can be integrated to meet what Ed Miliband claims is the biggest challenge in the history of the NHS.

The Labour leader will highlight the gap between NHS and care demand which is expected in coming years, and current funding.

HSJ revealed in January that shadow health secretary Andy Burnham was developing plans for the vast majority of NHS funding to councils.

Mr Miliband will today claim integration is being damaged by the government’s “free market ideology”.

An Independent Commission on Whole-Person Care will be set up and led by former Department of Health clinical lead for efficiency and productivity Sir John Oldham, who is a GP.

Launching the commission on a visit to Lancashire today, Mr Miliband was expected to say: “The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.”

… continues on the site

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The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset’s Symphony Project – University of York, Centre for Health Economics – February 2014

Posted on March 5, 2014. Filed under: Chronic Disease Mgmt, Health Economics | Tags: , |

The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset’s Symphony Project – University of York, Centre for Health Economics – February 2014

Panos Kasteridis, Andrew Street, Matthew Dolman, Lesley Gallier, Kevin Hudson, Jeremy Martin and Ian Wyer

“Abstract
Aims
Since the inception of the NHS, an ever-present challenge has been to improve integration of care within the health care system and with social care. Many people have complex and ongoing care needs and require support from multiple agencies and various professionals. But care is often fragmented and uncoordinated, with no one agency taking overall responsibility, so it is often left to individuals and their families to negotiate the system as best they can. South Somerset’s Symphony is designed to establish greater collaboration between primary, community, acute and social care, particularly for people with complex conditions.”

… continues on the sites

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Safe, compassionate care for frail older people using an integrated care pathway: Practical guidance for commissioners, providers and nursing, medical and allied health professional leaders – NHS England – February 2014

Posted on February 28, 2014. Filed under: Aged Care / Geriatrics, Patient Safety | Tags: |

Safe, compassionate care for frail older people using an integrated care pathway: Practical guidance for commissioners, providers and nursing, medical and allied health professional leaders – NHS England – February 2014

Frail older people – Safe, compassionate care
Practical guidance for commissioners, providers and nursing, medical and allied health professional leaders

“If frail older people are supported in living independently and understanding their long-term conditions, and educated to manage them effectively, they are less likely to reach crisis, require urgent care support and experience harm.

The practical guidance document summarises the evidence of the effects of an integrated pathway of care for older people and suggests how a pathway can be commissioned effectively using levers and incentives across providers.

 

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Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

Posted on February 21, 2014. Filed under: General Practice, Primary Hlth Care | Tags: , , |

Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

“As England’s population both expands and ages, so the demands on primary care will grow. Within the current commissioning and funding system innovative models of primary care provision are already being used. This report describes examples of these through four case studies in different areas of England. It also highlights how the existing system is imperfectly understood, particularly regarding contracts.

Building on ideas articulated in previous work, the report argues for a new approach that brings together funding for general practice with funding for many other services. It would entail new forms of commissioning, with GPs innovating in how care is delivered. Over time, the report foresees ‘family care networks’ emerging that provide forms of care well beyond what is currently available in general practices.”

 

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Measuring the Outcomes of Case Managed Community Care. Towards a practical instrument for Australian home support – 2013

Posted on February 19, 2014. Filed under: Community Services, Health Systems Improvement | Tags: |

Measuring the Outcomes of Case Managed Community Care. Towards a practical instrument for Australian home support – 2013

Sarah Redshaw & Michael Fine

Centre for Research on Social Inclusion, Department of Sociology, Macquarie University, Sydney
ISBN: 978-1-74138-401-7

Extract from the executive summary:

“The research has been designed to test, document and apply standard measures for the determination of client outcomes in case managed community care for older people. Stage One, the first year of the research program, completed in 2012-2013, was a rigorous pilot study undertaken in the three well established and experienced case management services in New South Wales: KinCare, Community Care Northern Beaches, and the Benevolent Society. In Stage Two, to be conducted in years two and three, the successful approaches identified in the first stage will be further trialled through case managed and other suitable services for older people across the State and the larger data sets used to examine the outcomes of case managed care and assess the effectiveness of the tools developed. The project and continuation of funding was subject to quarterly reviews by the university and annual reviews by the research partners.”

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Many to many: How the relational state will transform public services – IPPR – 12 February 2014

Posted on February 18, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement, Patient Participation | Tags: |

Many to many: How the relational state will transform public services – IPPR – 12 February 2014

“This landmark report sets out a new ‘relational state’ agenda for public service reform that would address complex problems holistically, provide more intensive and personalised engagement at the frontline of service delivery, and empower and engage citizens.

We need a radical reconfiguration of our public services to make them better able to tackle the complex challenges – such as antisocial behaviour, chronic ill-health, and long-term unemployment – that are consuming a growing proportion of public expenditure. In the past, public service reform has relied too heavily on bureaucratic and market-based tools that are ill-equipped to deal with these problems.

In this publication, the authors set out how we can build a more relational state in practice, and consider how the lessons offered by some cutting-edge initiatives could help reshape mainstream services. By managing public services as interconnected and decentralised systems, promoting deep relationships and neighbourhood-based approaches in key services, and designing institutions that enable citizens to tackle shared problems together, we can make those services fit for the more complex times that we live in.”

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Service transformation: Lessons from mental health – The King’s Fund – 4 February 2014

Posted on February 5, 2014. Filed under: Health Systems Improvement, Mental Health Psychi Psychol | Tags: , |

Service transformation: Lessons from mental health – The King’s Fund – 4 February 2014

” Mental health services have undergone radical transformation in the past 30 years. A community-based care model has largely replaced the acute and long-term care provided in large institutions.

Similar change – from hospital to community-based alternatives – is a long-standing policy objective for physical health care in the United Kingdom. How far the two can be compared has been remarkably under-explored. This paper seeks to correct this by examining the transformation of mental health services in England and the relevance to current policy. Drawing on workshops with those involved in the changes and a review of published literature, the paper explores the context and factors that enabled change to happen in mental health. It includes 10 lessons for service transformation based on these experiences.”

… continues on the site

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Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014

Posted on January 31, 2014. Filed under: Aged Care / Geriatrics, Chronic Disease Mgmt, Health Mgmt Policy Planning | Tags: , , |

Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014

by Nick Goodwin, Anna Dixon, Geoff Anderson, Walter Wodchis

“Lessons from seven international case studies

Around the world, rapidly ageing populations are resulting in increased demand for health and social care services, which presents significant challenges for national health and care systems. Many have adopted an integrated care approach to meet the needs of older people with chronic or multiple conditions. This approach often involves a single point of entry – designating a care manager to help with assessing needs, sharing information, and co-ordinating care delivery by multiple caregivers (formal and informal).

This report synthesises evidence from seven case studies covering Australia, Canada, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States. It considers similarities and differences of programmes that are successfully delivering integrated care, and identifies lessons for policy-makers and service providers to help them address the challenges ahead.”

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Sustainable, resilient, healthy people & places: a sustainable development strategy fo the NHS, Public Health and Social Care system – NHS England, Sustainable Development Unit – January 2014

Posted on January 30, 2014. Filed under: Environmental Health, Health Mgmt Policy Planning | Tags: , , |

Sustainable, resilient, healthy people & places: a sustainable development strategy fo the NHS, Public Health and Social Care system – NHS England, Sustainable Development Unit – January 2014

“The approach described in this strategy is the result of intensive engagement across the health and care system. It describes the most important principles and opportunities that can be taken to enable a more sustainable health and care system over the next five years. These align with the current policy direction for integrated care closer to home and we know this is what the public expects of us.”

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Integrated care value case toolkit – Local Government Association [UK] – 17 January 2014

Posted on January 28, 2014. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care value case toolkit – Local Government Association [UK] – 17 January 2014

“The LGA has partnered with NHS England, The Association of Directors of Adult Social Services (ADASS), The Association of Directors of Children’s Services (ADCS), Monitor, NHS Confederation and the Department of Health (DH) to deliver a programme of work carried out by Integrating Care.

The toolkit should enable Health and Wellbeing Boards and local partners to understand the evidence and impact of different integrated care models on service users, as well as the associated impact on activity and cost to different parts of the health and care system.”

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Delivering integrated care and support – The Institute for Research and Innovation in Social Services (IRISS) – December 2013

Posted on January 16, 2014. Filed under: Social Work | Tags: , , |

Delivering integrated care and support – The Institute for Research and Innovation in Social Services (IRISS) – December 2013

“Document that is the second review of research evidence completed for ADSW [Association of Directors of Social Work] by Professor Alison Petch from IRISS on the factors that underpin best health and social care integrated practice.

The original document, An evidence base for the delivery of adult services, published in 2011, presented the evidence for considering factors beyond those of structural change when planning to improve integrated outcomes for individuals. This latest report, Delivering integrated care and support, further adds to the knowledge base by focusing on the key dimensions for effective implementation of change.”

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Think integration, think workforce: three steps to workforce integration – Centre for Workforce Intelligence – December 2013

Posted on January 16, 2014. Filed under: Workforce | Tags: , , |

Think integration, think workforce: three steps to workforce integration – Centre for Workforce Intelligence – December 2013

“Integration offers important potential benefits including:

better outcomes for people who use services
more efficient use of existing resources
improved access to health, social care and support services.

The paper identifies three steps for workforce leaders to promote integration from a workforce perspective:

Be clear about the local integration agenda, including the various routes to integration
Address the integrated workforce management challenge to ensure the right people with the right skills and behaviour are in place to deliver integrated services around individuals’ needs.
Implement successful workforce change by addressing a range of operational and strategic questions by taking an inclusive approach.”

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Public Health England and NHS Improving Quality announce changes to the End of Life Care Co-ordination Information Standard – 10 January 2014

Posted on January 14, 2014. Filed under: Health Informatics, Palliative Care | Tags: , , |

Public Health England and NHS Improving Quality announce changes to the End of Life Care Co-ordination Information Standard – 10 January 2014

“The standard specifies the core content to be held in Electronic Palliative Care Co-ordination Systems (EPaCCS), or paper-based care co-ordination systems. Evidence is emerging that the standard improves care co-ordination, supporting more people to die in their place of choice (What we know now 2013, PHE National End of Life Care Intelligence Network).

Some changes have been made to the standard following feedback from implementers and key stakeholders and these have recently been published by the Information Standards Board for Health and Social Care. They include:

new data item to record consent status
data item to record actual place of death moved to core data set
data item to record date of death
subset of codes now specified for the disability data item
additional codes for the data item on informal carer, prescription of palliative care medication and formal carers involved in care
data item for main informal carer to be mandatory for completion
removal of non-specific codes for primary end of life care diagnosis
removal of Liverpool Care Pathway (LCP) from the data item that records ‘End of Life Care Tools in Use’ ”

… continues on the site

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Measuring people’s experiences of integrated care; an options appraisal and a recommended set of questions – Picker Institute Europe – 8 January 2014

Posted on January 10, 2014. Filed under: Health Mgmt Policy Planning, Patient Journey | Tags: , , |

Measuring people’s experiences of integrated care; an options appraisal and a recommended set of questions – Picker Institute Europe – 8 January 2014

Developing measures of people’s self-reported experiences of integrated care – Picker Institute Europe – 8 January 2014

An options appraisal on the measurement of people’s experiences of integrated care – Picker Institute Europe – 8 January 2014

Media release: Measuring health and social care integration: new research and recommendations

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Health and care integration: making the case from a public health perspective – Public Health England – 19 December 2013

Posted on December 24, 2013. Filed under: Health Mgmt Policy Planning, Public Hlth & Hlth Promotion | Tags: , |

Health and care integration: making the case from a public health perspective – Public Health England – 19 December 2013

“The aim of this document is to help local areas, in particular health and wellbeing boards, make the case for integration focused on individuals’ health and wellbeing as well as their quality of life if they become sick.”

 

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Liaison psychiatry for every acute hospital: integrated mental and physical healthcare – Royal College of Psychiatrists – December 2013

Posted on December 24, 2013. Filed under: Mental Health Psychi Psychol | Tags: , |

Liaison psychiatry for every acute hospital: integrated mental and physical healthcare – Royal College of Psychiatrists – December 2013

“Liaison psychiatry is a critical service that should be integral to all acute hospitals. Services comprise multidisciplinary teams skilled to integrate mental and physical healthcare in people whose mental health problems arise in, or have an impact on management of, physical illness and symptoms.

The report starts with chapters that summarise existing evidence of need for liaison psychiatry services in all acute hospitals and then provides evidence for the range of problems Addressed, and range of interventions required, to meet core mental health demands in acute hospitals.

Further chapters show case examples that demonstrate the benefit of services; provide detailed considerations for service design, including principle organisational standards, access and response standards, hours of operation, remit and staffing; governance is addressed as a range of clinical and organisational risks and how these can be reduced by liaison psychiatry services are described. Lastly, key considerations required to set local standards for common mental health-related problems that occur in acute hospitals are provided. Each chapter ends with a summary of the key messages.

This report replaces CR118. Psychiatric services to accident and emergency departments from 2004.”

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Think integration, think workforce: three steps to workforce integration – Centre for Workforce Intelligence – 19 December 2013

Posted on December 20, 2013. Filed under: Workforce | Tags: |

Think integration, think workforce: three steps to workforce integration – Centre for Workforce Intelligence – 19 December 2013

Media release

“Aimed at workforce leaders and senior workforce specialists, the paper identifies a range of workforce implications arising from integrating health and social care and identifies clear steps to support workforce integration.

Think integration, think workforce is based on a review of literature on the subject as well as interviews with sector leaders and workforce specialists, including a recent round table seminar which discussed the early findings.

The paper identifies three steps for workforce leaders to promote integration from a workforce perspective:

Be clear about the local integration agenda, including the various routes to integration.
Address the integrated workforce management challenge to ensure the right people with the right skills and behaviour are in place to deliver integrated services around individuals’ needs.
Implement successful workforce change by addressing a range of operational and strategic questions by taking an inclusive approach.”

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Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis – NHS National Institute for Health Research – November 2013

Posted on November 7, 2013. Filed under: Chronic Disease Mgmt, Health Economics | Tags: , , |

Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis – NHS National Institute for Health Research – November 2013

Lewis GH, Georghiou T, Steventon A, Vaithianathan R, Chitnis X, et al. Impact of ‘Virtual Wards’ on hospital use: a research study using propensity matched controls and a cost analysis. Final report. NIHR Service Delivery and Organisation programme; 2013.

Extract from the executive summary

“Background
Health care systems in many developed countries are currently under financial strain because of ageing populations, the rising prevalence of various chronic diseases, and budgetary constraints resulting from the global economic downturn.

The costs of providing health care are highly skewed across the population, with a small number of patients accounting for a large proportion of expenditure. Since unplanned hospital admissions account for a high proportion of costs, considerable resources could potentially be invested in providing preventive care for a relatively small number of costly patients and yet still potentially yield net savings overall from averted future hospital costs. In practice, however, such savings have been difficult or impossible to demonstrate.

One reason why preventive interventions may be unsuccessful at reducing demand is if they are offered to patients who are at insufficiently high risk of future unplanned hospital admission. In 2005, the Department of Health commissioned two “case finding” tools for improving the identification of high-risk patients in England. Known as “PARR” and the “Combined Model”, these predictive risk tools are now used in many parts of the country to select which high-risk patients should be offered a hospital-avoidance intervention.

One such intervention is the “virtual ward”. This model of care uses the staffing, systems and daily routines of a hospital ward to deliver preventive care to patients in their own homes in the aim of mitigating their risk of unplanned hospitalisation. Whilst virtual wards have been introduced in many parts of the UK and overseas, their efficacy and cost-effectiveness has yet to be determined.”

… continues

Related Article from the International Journal of Integrated Care

Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites – November 2013

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Safety in Canadian health care organizations: A focus on transitions in care and Required Organizational Practices – Canadian Health Accreditation Report – 21 October 2013

Posted on October 25, 2013. Filed under: Patient Safety | Tags: , , |

Safety in Canadian health care organizations: A focus on transitions in care and Required Organizational Practices – Canadian Health Accreditation Report – 21 October 2013

Accreditation Canada. (2013). Safety in Canadian health care organizations: A focus on transitions in care and Required Organizational Practices. Ottawa, ON: Accreditation Canada.

“The Accreditation Canada standards and patient safety goals—the Required Organizational Practices—identify the importance of communication and transfer of information. This year’s Canadian Health Accreditation Report highlights how Canadian health care organizations are performing relative to care transitions—handovers at shift changes, client transfers, discharges, and referrals to other health services providers—which play a critical role in providing safe and quality health care. The second part of this year’s report showcases areas of excellence achieved by Canadian health care organizations and opportunities for improvement relative to the Accreditation Canada Required Organizational Practices—over the past years and moving forward.”

 

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Co-ordinated care for people with complex chronic conditions – King’s Fund – 24 October 2013

Posted on October 25, 2013. Filed under: Chronic Disease Mgmt | Tags: , , |

Co-ordinated care for people with complex chronic conditions – King’s Fund – 24 October 2013

More, including case studies 

“The costs of caring for people with age-related chronic and complex medical conditions are high and will continue to rise with population ageing. Yet people with multiple health and social care needs often receive a very fragmented service, resulting in less than optimal care experiences, outcomes and costs. Many countries have developed strategies to improve care co-ordination, but these have often failed to achieve their objectives. There is also a general lack of knowledge about how best to apply (and combine), in practice, the various strategies and approaches to care co-ordination.

This report presents the findings from a two-year research project funded by Aetna and the Aetna Foundation, which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. It elicits some key lessons and markers for success to help identify how care co-ordination might be transferred from the UK to the US context.”

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Integrated care – policy issue reviews – Primary Health Care Research and Information Service – September 2013

Posted on October 24, 2013. Filed under: Primary Hlth Care | Tags: , |

Integrated care – policy issue reviews – Primary Health Care Research and Information Service – September 2013

Integrated care: What policies support and influence integration in health care in Australia? Report 1

Integrated care: What policies support and influence integration in health care across New Zealand, England, Canada and the United States? Report 2

Integrated care: What strategies and other arrangements support and influence integration at the meso/organisational level? Report 3

Medicare Locals: A model for primary health care integration? Report 4

Integrated care: What can be done at the micro level to influence integration in primary health care? Report 5

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Strengthening people-centred health systems in the WHO European Region: a roadmap – WHO – 22 October 2013

Posted on October 24, 2013. Filed under: Health Systems Improvement | Tags: , |

Strengthening people-centred health systems in the WHO European Region: a roadmap – WHO – 22 October 2013

News release: Framework for Action towards Coordinated/Integrated Health Services Delivery (CIHSD) launched

“WHO/Europe is developing the Framework for the European Region, and launched the work plan for it at the conference “Health systems for health and wealth in the context of Health 2020”, held on the fifth anniversary of the signing of the Tallinn Charter in Estonia.

The Framework’s goal is to support countries with policy options and recommendations that target key areas for strengthening the coordination/integration of health services. These changes are in line with the vision of Health 2020 and the values of universal health coverage, as the delivery of care must be of high quality and people centred to secure improvements in health and equity.

Discussions throughout the conference called attention to the importance of moving health-service delivery towards more people-centred care, with the coordination/integration of delivery being a key approach.

A WHO/Europe roadmap explains the process of developing the Framework for Action towards CIHSD, setting out the phases from now to 2016. It gives particular attention to ensuring the participation of partners, including a network of focal points in Member States, external experts and leading organizations in the field, such as the International Foundation for Integrated Care.”

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Crossing Boundaries – Mental Health Foundation [UK] – September 2013

Posted on September 6, 2013. Filed under: Mental Health Psychi Psychol | Tags: , |

Crossing Boundaries – Mental Health Foundation [UK] – September 2013

“This report sets out the findings from the Mental Health Foundation’s Inquiry into integrated health care for people with mental health problems. The Inquiry ran from April 2012 to June 2013. Its aim was to identify good practice, generate discussion, and draw up key messages on integrated healthcare for people with mental health problems.”

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Networks that work: partnerships for integrated care and services – Nesta – August 2013

Posted on September 4, 2013. Filed under: Health Mgmt Policy Planning | Tags: , , , |

Networks that work: partnerships for integrated care and services – Nesta – August 2013

“This report shows how consortia work in practice, what the barriers are and how these barriers can be overcome.

Case studies detail how networks can support the integration of care and services in different ways, including commissioning services together, providing services together and delivering services together.

The work of the People Powered Health teams has shown that three core actions are necessary for partnerships to be successful – establishing a common purpose, developing a shared culture and enabling information sharing and open dialogue.”

 

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Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013

Posted on July 24, 2013. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013

“At a time when policy-makers in England have made a commitment to bring about closer integration of care both within the NHS and between health and social care, what can the health and social care system in England learn from the experiences of the other countries of the United Kingdom?

Integrated care in Northern Ireland, Scotland and Wales examines the context in which health and social care is provided; identifies policy initiatives that promote integrated care and the impact of these initiatives; and considers the barriers and challenges to achieving integrated care. The King’s Fund commissioned authors in each of the three countries to write a paper considering these issues. The authors reflect on what England can learn, drawing on their own experience of what has and has not been achieved.

The report concludes that structural integration of health and social care will not bring benefits in itself but must be accompanied by other changes.”

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Moving care to the community: an international perspective – Royal College of Nursing – 23 May 2013

Posted on June 13, 2013. Filed under: Community Services, Nursing | Tags: , |

Moving care to the community: an international perspective – Royal College of Nursing – 23 May 2013

Media release

“The Royal College of Nursing (RCN) today expressed concern that patients in the UK, who could be cared for at home, face longer stays in hospital due to under-resourced community services.”

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Enabling people to live well: fresh thinking about collaborative approaches to care for people with long-term conditions – The Health Foundation – May 2013

Posted on May 21, 2013. Filed under: Chronic Disease Mgmt | Tags: , , |

Enabling people to live well: fresh thinking about collaborative approaches to care for people with long-term conditions – The Health Foundation – May 2013

“This is the report of a research project undertaken by Professors Vikki Entwistle and Alan Cribb.

The project:

critically analysed the ways that collaborative approaches are currently described
started to examine what goes on in practice when clinicians and patients work together in ways they appreciate as meaningfully collaborative.

The project used a combination of philosophical analysis and discussions with clinicians and patients experienced in collaborative approaches to managing long-term conditions.

In the report, the authors reflect on clinicians’ and patients’ experiences and draw on ideas from development economics and social justice. They argue that thinking in terms of people’s capabilities, and how they live in relationship with others, may be able to help us understand and overcome some of the barriers to more collaborative working between health professionals and patients with long-term conditions.

The report also makes clear that, while the ways people describe collaborative approaches to healthcare can be helpful in indicating how care could be delivered differently, they can also be counter-productive. Current descriptions are developed within the dominant and traditional way of thinking about the patient-health professional relationship and this could be limiting the uptake and effectiveness of more collaborative ways of working.

Making care truly person-centred requires radically different ways of thinking. The ideas explored in this report suggest fresh ways of thinking about how patients and clinicians can work together in a meaningful partnership. Thinking in terms of capabilities and relational autonomy will not resolve tensions between patient and clinician priorities, but these concepts can help support much-needed discussion.”

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Evaluation of the first year of the Inner North West London Integrated Care Pilot – Nuffield Trust – 17 May 2013

Posted on May 20, 2013. Filed under: Aged Care / Geriatrics, Chronic Disease Mgmt | Tags: , |

Evaluation of the first year of the Inner North West London Integrated Care Pilot – Nuffield Trust – 17 May 2013

“This report outlines the findings of our evaluation of the Inner North West London Integrated Care Pilot, which aimed to develop new forms of care for older people and those with diabetes.”

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Integrated Care: Our Shared Committment – Gov.UK – 13 May 2013

Posted on May 15, 2013. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , |

Integrated Care: Our Shared Committment – Gov.UK – 13 May 2013

“A framework that outlines ways to improve health and social care integration.

This framework document on integration, signed by 12 national partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.”

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Does integrated care deliver the benefits expected? – RAND – May 2013

Posted on May 14, 2013. Filed under: Health Mgmt Policy Planning | Tags: , , |

Does integrated care deliver the benefits expected? – RAND – May 2013

Findings from 16 integrated care pilot initiatives in England

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Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees – Office of the National Coordinator for Health Information Technology – 21 March 2013

Posted on April 2, 2013. Filed under: Chronic Disease Mgmt, Health Informatics | Tags: , |

Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees – Office of the National Coordinator for Health Information Technology – 21 March 2013

LTPAC = long-term and post-acute care

“the grantees have identified strategies and approaches that can be widely adopted by communities seeking to improve transitions of care to and from LTPAC providers:
• Common processes and appropriate connection points for clinical information transfer between hospitals and LTPAC providers
• Recommendations for hospital and LTPAC provider data needs
• Strategies to promote the use of standards based technology to create, transmit and view clinical documents of relevance to LTPAC
• Approaches to engage LTPAC providers where they are today across the health IT adoption spectrum (from high adoption to no adoption)

In addition, the grantees have encountered challenges that will need to be addressed by any community seeking to address this issue:
• Uneven adoption of non-certified electronic health records makes connections between acute and post acute care providers challenging and labor intensive
• High staff turnover rates create implementation and ongoing operational challenges”

… continues

 

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Best practice for commissioning diabetes services: An integrated care framework – NHS – March 2013

Posted on March 27, 2013. Filed under: Diabetes | Tags: |

Best practice for commissioning diabetes services: An integrated care framework – NHS – March 2013

Executive summary

“Diabetes mellitus is a complex condition that has a profound impact on the quality of life of people living with the condition and on the health economy as a whole. From the time of diagnosis to the development of severe complications such as foot amputations, the person with diabetes receives input from a wide spectrum of health and social care professionals. When this care is delivered in a fragmented manner it results in duplication, inefficiency and, worst of all, a poorer health experience.

As people with diabetes become older, we need to ensure their lives are not blighted by a toxic and expensive combination of conflicting priorities, poly-pharmacy and avoidable complications.”

… continues

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Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013

Posted on March 22, 2013. Filed under: Aged Care / Geriatrics, Chronic Disease Mgmt | Tags: , , |

Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013

“The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care.

Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice.

There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice.

Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration.”

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Integrated care: what do patients, service users and carers want? – RightCare essential reading – December 2012

Posted on January 11, 2013. Filed under: Health Mgmt Policy Planning | Tags: , , , |

Integrated care: what do patients, service users and carers want? – RightCare essential reading – December 2012

A Reading List produced by QIPP Right Care
Nicola Pearce-Smith, Information Scientist
Sir Muir Gray, Joint Lead for Right Care

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Six principles for delivering integrated out-of-hospital care – NHS Confederation – 19 December 2012

Posted on January 4, 2013. Filed under: Community Services, General Practice | Tags: , |

Six principles for delivering integrated out-of-hospital care – NHS Confederation – 19 December 2012

“Adopting six key principles will help the delivery of effective integrated out-of-hospital care, says a new report by the NHS Confederation and Royal College of General Practitioners.”

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Patients’ experience of integrated care. A report from the Cancer Campaigning Group [UK] – 20 November 2012

Posted on November 21, 2012. Filed under: Oncology, Patient Participation | Tags: |

Patients’ experience of integrated care. A report from the Cancer Campaigning Group [UK] – 20 November 2012

Media release

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Order from Chaos: Accelerating Care Integration – National Patient Safety Foundation [US] – October 2012

Posted on October 31, 2012. Filed under: Patient Safety | Tags: , , |

Order from Chaos: Accelerating Care Integration – National Patient Safety Foundation [US] – October 2012

Report of the Lucian Leape Institute Roundtable On Care Integration

“Health care today presents a difficult challenge: as our ability to recognize and treat disease continues to grow, so too does the complexity of delivering those solutions to each patient and to populations. Too often, care integration–the planned, thoughtful design of the care process for the benefit and protection of the patient—is lacking. This report addresses the issue of care integration with the aim of outlining the major barriers to effective integration and providing a framework for further consideration and action among stakeholders.”

Report

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From vision to action. Making patient-centred care a reality – Richmond Group of Charities [UK] – 2012

Posted on October 23, 2012. Filed under: Chronic Disease Mgmt, Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: , , , |

From vision to action. Making patient-centred care a reality – Richmond Group of Charities [UK] – 2012

Extract from the foreword:

“When our ten leading health and social care charities published our joint view on how high-quality, patient-centred, cost-effective care could be delivered, we were surprised how aligned our thinking was. We agreed five themes on which the post-reform NHS should be based
and within which productivity gains are possible:
• co-ordinated care
• patients engaged in decisions about their care
• supported self-management
• prevention, early diagnosis and intervention
• emotional, psychological and practical support.

Our shared vision has yet to be delivered. The Health Select Committee recently warned the government that if standards of quality and access are to be maintained, system redesign is needed, rather than salami-slicing existing services or incremental improvement (House of Commons Health Committee 2012). We agree.

As leading charities that both advocate for and support the care of people with health and social care needs, we renew our commitment to working with colleagues locally and nationally, in policy and in service delivery, to build a sustainable model for the NHS and its partners.”

… continues

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How to deliver high-quality, patient-centred, cost-effective care. Consensus solutions from the voluntary sector – Richmond Group of Charities [UK] – 2010

Posted on October 23, 2012. Filed under: Chronic Disease Mgmt, Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: , , , |

How to deliver high-quality, patient-centred, cost-effective care. Consensus solutions from the voluntary sector – Richmond Group of Charities [UK] – 2010

Extract from the introduction:

“This publication is the collective effort of ten of the leading health and social care organisations in the voluntary sector. Each organisation submitted evidence to The King’s Fund, which independently analysed and assessed each submission and worked with the organisations to establish a common position. Together we have identified the five key themes that the health and social care system must embrace to be sustainable and to ensure quality. The themes are:
•co-ordinated care
•patients engaged in decisions about their care
•supported self-management
•prevention, early diagnosis and intervention
•emotional, psychological and practical support”

…  continues

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The Accountable Lead Provider. Developing a powerful disruptive innovator to create integrated and accountable programmes of care – RightCare Casebook [NHS] – July 2012

Posted on October 2, 2012. Filed under: Chronic Disease Mgmt, Health Mgmt Policy Planning | Tags: , |

The Accountable Lead Provider. Developing a powerful disruptive innovator to create integrated and accountable programmes of care – RightCare Casebook [NHS] – July 2012

Professor Paul Corrigan and Dr Steven Laitner

Extract from the executive summary:

“Public experience of NHS services is marked by praise for the specific experiences of treatment but problems with the overall experience of service. Whilst most staff and leaders in the NHS recognise the severe problems caused by the organisation of care into episodes of care, there are few models of integrated care that have emerged which have sufficient integrative power to challenge the organisational distinction of episodic care. This is partly because those arguing for integration do so usually within the episodic paradigm but also because they want to develop a new model of integration without disrupting the old model of episodic care.

Here we argue for a strong integrator who is given the power through the contract to both deliver care and also to bring together the previously episodic providers of care into a single pathway. The lead provider in this model is given the responsibility through the contract for subcontracting for the various aspects of care. The contract demands of the lead provider that he carry out that role in such a way as to ensure all of the different aspects of care are fully integrated.”

… continues

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National evaluation of Department of Health’s integrated care pilots [UK] – March 2012, released 22 May 2012

Posted on May 25, 2012. Filed under: Health Mgmt Policy Planning | Tags: |

National evaluation of Department of Health’s integrated care pilots [UK] – March 2012, released 22 May 2012

Author:    Ernst & Young, RAND Europe and the University of Cambridge

“Key messages

● While much of the wider literature focuses on ‘models’ of integrated care, we found that Integrated Care Pilots (ICPs) developed and implemented a loose collection of ‘integrating activities’ based on local circumstances. Despite the variations across the pilots, a number of aims were shared: bringing care closer to the service user; providing service users with a greater sense of continuity of care; identifying and supporting those with greatest needs; providing more preventive care; and reducing the amount of care provided unnecessarily in hospital settings.

● Most pilots concentrated on horizontal integration – e.g., integration between community-based services such as general practices, community nursing services and social services rather than vertical integration – e.g., between primary care and secondary care.

● Integrated care led to process improvements such as an increase in the use of care plans and the development of new roles for care staff. Staff believed that these process improvements were leading to improvements in care, even if some of the improvements were not yet apparent. A range of other improvements in care were reported by pilots following local evaluations. We have reported these but they  lie beyond the scope of the national evaluation.

● Patients did not, in general, share the sense of improvement. This could have been because the process changes reflected the priorities and values of staff (a so-called professionalisation of services); because the benefits had not yet become apparent to service users (‘too early to tell’); because of poor implementation; or because the interventions were an ineffective way to improve patient experience. We believe that the lack of improvement in patient experience was in part due to professional rather than user-driven change, partly because it was too early to identify impact within the timescale of the pilots, and partly because, despite having project management skills and effective leadership, some pilots found the complex changes they set for themselves were harder to deliver than anticipated. We also speculate that some service users (especially older patients) were attached to the pre-pilot ways of delivering care, although we recognise this may change over time.”

… continues

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Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways – AHRQ – 29 February 2012

Posted on March 29, 2012. Filed under: Community Services, Preventive Healthcare, Primary Hlth Care | Tags: , , |

Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways – AHRQ – 29 February 2012

AHRQ = Agency for Healthcare Research and Quality

“Developed by: Community Care Coordination Learning Network

This quick start guide is a reference and resource for public and private stakeholders engaged in improving the system for identifying and connecting at-risk individuals within a community to appropriate health and social services. The target audience includes all those involved in the design, implementation, and financing of care coordination services. This Quick Start guide complements Connecting Those at Risk to Care: A Guide to Building a Community “HUB” To Promote a System of Collaboration, Accountability, and Improved Outcomes.

Contents:

Overview

Why Create a Community HUB and Pathways?
Reason #1: To Promote the Goals of Health Care Reform
Reason #2: To Close the Nation’s Cost and Quality Gap by Paying for Value, Not Volume

A Quick Guide to Creating and Using a Community HUB and Pathways
Key Elements of an Effective Community HUB
A Step-by-Step Process for Using a Pathway

Examples of Six Core Pathways
Core Pathway 1: Medical Home
Core Pathway 2: Medical Referral
Core Pathway 3: Social Service Referral
Core Pathway 4: Health Insurance
Core Pathway 5: Medication Assessment
Core Pathway 6: Pregnancy

Other Resources

Appendix A: Pathways Compendium

Exhibits
Exhibit A-1: Sample Demographic and Referral Form
Exhibit A-2: Sample Care Planning Checklists
Exhibit A-3: Followup Adult Checklist
Exhibit A-4: Examples of Reports for the Community HUB and Participating Agencies”

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National Evaluation of the Department of Health’s Integrated Care Pilots. Final report – RAND Europe, Ernst & Young LLP, prepared for the Department of Health – March 2012

Posted on March 27, 2012. Filed under: Health Mgmt Policy Planning | Tags: , |

National Evaluation of the Department of Health’s Integrated Care Pilots [UK]. Final report – RAND Europe, Ernst & Young LLP, prepared for the Department of Health – March 2012

Key messages
● While much of the wider literature focuses on ‘models’ of integrated care, we found that Integrated Care Pilots (ICPs) developed and implemented a loose collection of ‘integrating activities’ based on local circumstances. Despite the variations across the pilots, a number of aims were shared: bringing care closer to the service user; providing service users with a greater sense of continuity of care; identifying and supporting those with greatest needs; providing more preventive care; and reducing the amount of care provided unnecessarily in hospital settings.
● Most pilots concentrated on horizontal integration – e.g., integration between community-based services such as general practices, community nursing services and social services rather than vertical integration – e.g., between primary care and secondary care.
● Integrated care led to process improvements such as an increase in the use of care plans and the development of new roles for care staff. Staff believed that these process improvements were leading to improvements in care, even if some of the improvements were not yet apparent. A range of other improvements in care were reported by pilots following local evaluations. We have reported these but they lie beyond the scope of the national evaluation.
● Patients did not, in general, share the sense of improvement.” … continues on the site

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Winning Conditions to Improve Patient Experiences: Integrated Healthcare in Ontario – Change Foundation – November 2011

Posted on December 7, 2011. Filed under: Health Mgmt Policy Planning | Tags: , |

Winning Conditions to Improve Patient Experiences: Integrated Healthcare in Ontario – Change Foundation – November 2011

“In this report, The Change Foundation offers its best advice on how Ontario can move closer to an integrated health system and improve the experience of  individuals and caregivers. It is based on work conducted and commissioned by the Foundation and on published research. It draws on what we have learned from other jurisdictions, and is informed by discussions with government officials, policy experts, regional planners and, most importantly, individuals and caregivers.”

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Towards integrated care in Trafford – Nuffield Trust – 10 November 2011

Posted on November 11, 2011. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , |

Towards integrated care in Trafford – Nuffield Trust – 10 November 2011

by Dr Sara Shaw and Ros Levenson

“This study of efforts in Trafford, Greater Manchester, to deliver integrated care provides valuable insights into the challenge of service reconfiguration at a time of financial constraint.”

… continues

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Principles for Integrated Care – National Voices – 25 October 2011

Posted on October 26, 2011. Filed under: Chronic Disease Mgmt, Patient Participation | Tags: , |

Principles for Integrated Care – National Voices – 25 October 2011

“The lack of joined-up care is the biggest frustration for patients, service users and carers. Conversely, achieving integrated care would be the biggest contribution the health and care services could make to improving quality and safety.

Patients, service users and carers want continuity of care, smooth transitions between care settings, and services that are responsive to all their needs together.

The Health and Social Care Bill 2011 will give the key commissioning and regulatory organisations in England duties to secure or promote integrated services. We, as organisations representing the interests of patients, service users and carers, want integrated care to develop quickly and at scale.

A range of different approaches should be developed and tested. There can be no single definition, model or system. However, there is a need for common principles to inform all the approaches – principles which put patients and service users at the heart of care.

We are asking the relevant Secretaries of State, all commissioners, regulators and relevant professional organisations to give explicit support to these principles.

Based on the experiences of service users, and research evidence, we state that integrated care must:”   … continues

News release: 30 Charities call on David Nicholson to endorse New Principles for Integrated Care

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Integrated care summary: What is it? Does it work? What does it mean for the NHS? – King’s Fund – 22 September 2011

Posted on September 23, 2011. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care summary: What is it? Does it work? What does it mean for the NHS? – King’s Fund – 22 September 2011

“Chris Ham summarises the different forms of integrated care and their impact so far on the NHS. Based on our major review of integrated care (Ham and Curry, 2010), it has been prepared in the light of the increased interest in integrated care arising out of the work of the NHS Future Forum and the government’s response.”

 

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Where next for integrated care organisations in the English NHS? – Nuffield Trust – 30 March 2010

Posted on April 7, 2010. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , , , , |

Where next for integrated care organisations in the English NHS? – Nuffield Trust – 30 March 2010
Author: Richard Q Lewis, Rebecca Rosen, Nick Goodwin & Jennifer Dixon

“Since the 1950s, the NHS has been looking at ways of improving care coordination. Lord Darzi’s NHS Next Stage Review introduced a new concept, that of the integrated care organisation (ICO). Since then, the Government has begun piloting schemes that offer different models of integrated care. This report, published jointly by The Nuffield Trust and The King’s Fund, examines some of these new models. It focuses in particular on organisations that combine commissioner and provider roles. These, the authors suggest, offer the most promise for aligning incentives to produce efficient care across primary, community and acute services.

Where next for integrated care organisations in the English NHS? forms part of work by both The Nuffield Trust and The King’s Fund examining new forms of structuring and delivering care over the coming decade.

This report will be of interest to healthcare policy-makers, senior managers and clinicians, and others involved in commissioning,as well as academics and students in the fields of healthcare and social policy.”

ISBN: 13-978-1-905030-42-2

Download full publication pdfDownloadable file: PDF, size: 629 KB

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From the ground up: a report on integrated care design and delivery – Integrated Care Network and the Institute of Public Care [UK] – January 2010

Posted on February 19, 2010. Filed under: Community Services, Health Mgmt Policy Planning | Tags: , , |

From the ground up: a report on integrated care design and delivery – Integrated Care Network and the Institute of Public Care [UK] – January 2010

“The report:
• Offers an overview of the policy framework for integration.
• Presents an outline of the approach to integration taken by four examples of different types of integrated care service.
• Analyses the elements of success in integrating care, and presents a model of design and delivery for managers to consider in relation to their own services and planning new facilities.
• Concludes with a range of hints and tips based on the research undertaken to develop this document.”

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Delivering Healthcare for London – An Integrated Strategic Plan 2010-2015

Posted on February 4, 2010. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , |

Delivering Healthcare for London – An Integrated Strategic Plan 2010-2015

Press Release:   A hundred polyclinics are on their way in London

“Possible locations for more than 100 polyclinics in London, which would see approximately three in each London borough, were released today by NHS London, the capital’s strategic health authority.

Polyclinics are a central part of the Healthcare for London (HfL) strategy, which aims to provide more care out of hospital and on the high street and closer to home, coupled with better specialised hospital care. Today’s First Stage Report sets out the latest thinking on the delivery of the strategy over the next five years, including the roll-out of polyclinics and changes to hospital services.” … continues on the web

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