Integrated Care

The lack of joined-up services is a major frustration for patients, service users and carers.

In its submission to the NHS Future Forum in May 2011 National Voices' top demand was for 'integration, integration, integration'.

The government then added a new focus on integration to the health service reforms. But there has been little consensus on what 'integration' means.

National Voices has made it a key priority to influence this debate so that 'integration' delivers what patients and service users want.

Contribution to Future Forum II

'What Patients Want From Integration' (January 2012) is a National Voices bespoke report for the Future Forum's integration workstream.

The paper says patients want good co-ordination of care and treatment - the 'integration' of service organisations is secondary. Any integrated care service must provide this care co-ordination at the point of use or it will fail. This golden rule was reflected in the Future Forum report and in the strategic report of the Nuffield Trust and the King's Fund.

The paper looks at the particular needs of three exemplar groups of service users and makes recommendations on, for example, integrating mental and physcial health; joining up local and specialist services; care planning; and medicines management and review.

Principles for integrated care

National Voices developed, with its members, a set of principles for integrated care which have been endorsed by Sir David Nicholson, chief executive of the NHS Commissioning Board.

These principles can help commissioners and providers to develop co-ordinated, person-centred care which uses voluntary and community organisations to best effect.

They havebeen widely welcomed by policy makers and referenced in the keynote report from the Kings Fund and Nuffield Trust which advises the government on how to develop integrated care strategy.

Webs of care -- what patients and service users experience

To understand why service users want integrated care, we need to understand their experiences of the fragmented systems they currently face.

To illustrate these experiences, National Voices has published seven 'webs of care' designed for us by patients, service users or their organisations. These show the complexity of the services which patients must navigate -- sometimes with little assistance to link them together.

The following example was created by Barbara Pointon, whose husband Malcolm lived with Alzheimer’s for many years.

Malcolm Pointon's 'web of care' -- Alzheimer's Disease

Click on the web for an enlarged version.

More webs of care here.

Integrated care -- resources

The NHS Future Forum report in January 2012 included recommendations from the integration workstream which the government has accepted.

A joint Nuffield Trust and King's Fund Report has been published advising the government on how to develop integrated care. The two organisations have also produced an easy-read slide pack outlining the key questions.

The NHS Confederation and Association of Adult Directors of Social Services have produced a joint paper on the way forward.