Integrated care for patients and populations: Improving outcomes by working together

^{An overview of the Nuffield Trust and The King’s Fund’s recommendations for the Department of Health for taking forward its strategy on integrated care}

Integrated care is essential to meet the needs of the ageing population, transform the way that care is provided for people with long-term conditions and enable people with complex needs to live healthy, fulfilling, independent lives. In its June 2011 summary report, the NHS Future Forum stated: ‘we need to move beyond arguing for integration to making it happen’.

The NHS Future Forum’s report built on the ideas that The King’s Fund and the Nuffield Trust presented as part of the Government’s Listening Exercise on the Health and Social Care Bill.

Developing integrated care should assume the same priority over the next decade as reducing waiting times had during the last

In response, the Department of Health approached The King’s Fund and the Nuffield Trust for help in supporting the development of its national strategy on integrated care and to feed ideas directly into the ongoing work of the NHS Future Forum.

Our resulting report: A report to the Department of Health and the NHS Future Forum: Integrated care for patients and populations: Improving outcomes by working together, examines:

• The case for integrated care;
• What current barriers to integrated care need to be overcome and how;
• What the Department of Health can do to provide a supporting framework to enable integrated care to flourish;
• Options for practical and technical support to those implementing integrated care, including approaches to evaluating its impact.

The report asserts that developing integrated care should assume the same priority over the next decade as reducing waiting times had during the last.

Its core recommendations are:

1. Government policy should be founded on a clear, ambitious and measurable goal to improve the experience of patients and service users and to be delivered by a defined date.
2. Setting an ambitious goal to improve patient experience should be reinforced by enhanced guarantees to patients with complex needs. These guarantees would include an entitlement to an agreed care plan, a named case manager responsible for co-ordinating care, and access to telehealth and telecare and a personal health budget where appropriate.
3. Change must be implemented at scale and pace. This will require work across large populations at a city- and county-wide level. There should be flexibility to take forward different approaches in different areas and to evaluate the impact, with the emphasis being on people with complex needs.

The report by Dr Nick Goodwin, Dr Judith Smith, Dr Alisha Davies, Claire Perry, Dr Rebecca Rosen, Dr Anna Dixon, Dr Jennifer Dixon, and Professor Chris Ham, makes a constructive contribution to the debate about integrated care. It will be of interest to policy-makers, health and social care commissioners and researchers with an interest in integrated care, as well as to health and social care organisations.