Headlines: July 24th, 2013

Integration of health, housing and social care services is crucial to the creation of sustainable care models for the future. This is the conclusion of a new report from the Good Governance Institute.

The report, Rethinking the Integration Agenda, examines the challenges that currently exist in delivering truly patient-centred care and, drawing on the experience of 16 leading experts from the housing, health and social care sectors, sets out three key pathways to address these challenges and overcome barriers to integration.

The report calls for a range of measures to overcome the barriers to integration. It argues that there should be ‘living well’ pathways to inform attitudes towards care services. This demands that both housing and community-based assets are brought to the table and included in debate about care. If nationally mandated and delivered at a local level, this broader approach to integration will lead to better patient outcomes.

It also calls for the development of 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.

There should also be 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.”

This report adds strength to a general trend of integrated services with local decision making. A recent publication from NHS England, ‘The NHS belongs to the people: a call to action’ reaffirmed the need for patient-centred, preventative care for people with long-term and complex conditions. The Community Budget pilots are demonstrating the benefits of pooling resources and bringing different professional groups together. The troubled families initiative is showing how working across professional boundaries not only turns around the lives of families, but also brings substantial cost savings.