Principles for integrated care
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 Act 2012 places duties on the key commissioning and regulatory organisations in England to promote integration. It also establishes Health and Wellbeing Boards that have a duty to encourage integrated working by contributing to Joint Strategic Needs Assessments (JSNAs) and joint health and wellbeing strategies.
We, as organisations representing the interests of patients, service users and carers, want these duties to develop into real integrated care quickly and at scale. A range of approaches should be developed and tested to enable these duties to be delivered in practice; 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:
- be organised around the needs of individuals (person-centred)
- focus always on the goal of benefiting service users
- be evaluated by its outcomes, especially those which service users themselves report
- include community and voluntary sector contributions
- be fully inclusive of all communities in the locality
- be designed together with the users of services and their carers
- deliver a new deal for people with long term conditions
- respond to carers as well as the people they are caring for
- be driven forwards by the commissioners
- be encouraged through incentives
- aim to achieve public and social value, not just to save money
- last over time and be allowed to experiment