A recently released briefing paper, prepared by the Nuffield Trust for Research and Policy Studies in Health Services, examines how local clinicians and managers are working together to develop closer service integration and less fragmented care for patients in the United Kingdom. The paper focuses on what is facilitating or impeding change, as well as setting out proposals for policy-makers in order to enable more rapid progress towards developing better coordinated services.
The authors use five case studies of health economies in the English National Health Service (NHS) — Torbay, Nottingham, Trafford, Cumbria and Redbridge — as a basis for their analysis. Emerging themes from the case studies are:
- Integrating primary, medical and community health services,
- Managing demand and developing new care models,
- Addressing an unsustainable acute sector,
- Establishing effective clinical leadership,
- Using data and information technology (IT) to integrate patient information,
- Involving the public,
- Establishing new forms of organization and governance, and
- Learning from the experience of integration abroad.
Several policy suggestions are given, including the need to develop closer service integration and less fragmented care for patients, such as implementing a policy on competition and collaboration. Other suggestions for improving integration include offering incentives to support integration, general practitioner budget-holding, improved social care, smarter regulation and the need for system leadership.
See “Removing the Policy Barriers to Integrated Care in England,” September 2010, available at www.nuffieldtrust.org.uk.