Integrated care will be tested by only 16 organisations

Posted on April 18, 2009. Filed under: Integrated care, Journals, Providers | Tags: , |

Just 16 organisations have made it onto the Department of Health’s integrated care pilot scheme.

The department had originally said it would select around 20 bids from more than 100 applicants.

Three strategic health authority areas – NHS South Central, NHS South East Coast and NHS West Midlands – have been left without a pilot scheme.

There were 36 organisations on the shortlist published last year, including bids representing all SHA regions.

NHS North East and NHS South West have four pilots each and the East Midlands, East of England and North West regions each secured two.

London and Yorkshire and the Humber have one pilot each.

A DH spokesperson said: “It was always intended there would be around 20 pilots.

“The chosen sites cover a range of diverse models, focusing on innovation and delivering an improvement in outcomes, quality and service user satisfaction.

“The selected sites provide an appropriate range and spread to conduct a robust evaluation.”

Pilot schemes

The schemes range from a primary care trust-led collaboration between GPs, public sector organisations and the third sector to improve dementia care for older people in Bournemouth and Poole to a scheme to help patients with chronic lung disease led by Northumbria Healthcare foundation trust.

Social care, the third sector and local authorities are also represented in pilot schemes.

Clinical areas include older people’s care, long term conditions, dementia, end of life care, cardiovascular disease, mental health and substance misuse.

The pilots were first proposed in Lord Darzi’s primary and community care strategy.

The announcement followed a King’s Fund debate where experts evaluated the lessons the NHS could learn from US healthcare, where integration is more established.

UnitedHealth executive vice president Simon Stevens, a former adviser to Tony Blair, said while it was important to create systems that were integrated through teamwork and infrastructure, no US integrated scheme was a local monopoly.

He said: “If you think about any of the leading integrated systems, there is a third party purchasing system.”

Sites selected by the DH from the shortlist of 36

  • Bournemouth and Poole PCT
  • Cambridge Assura LLP
  • Church View Medical Practice, Sunderland
  • NHS Cumbria
  • Cornwall and Isles of Scilly PCT
  • Durham Dales Integrated Care Organisation
  • Nene Commissioning CIC
  • Newcastle upon Tyne Hospitals foundation trust
  • NHS Norfolk and Norfolk county council
  • Northumbria Healthcare foundation trust
  • North Cornwall Practice-Based Commissioning Group
  • Principia – Partners in Health, Rushcliffe, South Nottinghamshire
  • NHS Tameside and Glossop
  • Torbay Care trust
  • Tower Hamlets PCT
  • Wakefield Integrated Substance Misuse Service

GPs to front integrated care pilot schemes

Pulse | By Nigel Praities | 1 April 2009

GPs will work with care homes, social services, acute trusts and charities to improve patient care under a range of pilot schemes to begin today.

The £4 million scheme involves 16 integrated care organisations in different areas of the country, focusing on health and social care professionals can work together to develop services for patients.

After 100 applications to run the schemes, the winning 16 pilots range from improving the co-ordination of end-of-life care, preventing cardiovascular disease and encouraging more self-care for people with long-term conditions.

The pilots begin today and will run for two years and will be evaluated for their effect on health outcomes, improved quality of care and service user satisfaction.

Health Minister Ben Bradshaw said this was an opportunity for patients to get all the health and social care they need in one place.

‘This programme provides an opportunity for clinicians – working closely with the community more widely – to use their on the ground knowledge to design services that are flexible, personalised and seamless,’ he said.

Integrated Care Pilots – Pilot Summaries

1. Bournemouth and Poole Teaching PCT

This pilot will be exploring a new model for delivering care for older people with dementia, involving collaboration between GPs, public sector organisations and third-sector services. It aims to provide a single point of access to an integrated community team.

2. Cambridge Assura LLP

This pilot will look at how different organisations across the health, social care and third sectors can better communicate and co-ordinate end-of-life care to enable people to be cared for and die in the place they choose. The pilot will also be improving public and patient engagement to ensure services are fully sensitive to user needs.

3. Church View Medical Practice, Sunderland

This pilot will improve quality of care and experience of services for the area’s population of older people. The local acute trust and GP practice will work together as an integrated organisation, and will work in partnership with the PCT provider arm, social services and the patient practice group. The pilot will aim to provide an improved, personalised experience through active management of long-term conditions.

4. NHS Cumbria

This pilot will be exploring a new approach to helping patients with chronic diseases to manage their own care. It will be focusing on increasing the collaboration between GP and patient. It will aim to move care into a community setting and reduce hospital admissions.

5. Durham Dales Integrated Care Organisation

This pilot will involve seven partner organisations working together to meet the needs of a rural population, provide continuity of care and reduce health inequalities. It will explore a number of different care pathways aiming to improve planning information, move care into a community setting, increase patient/carer satisfaction and reduce hospital admissions.

6. Nene Commissioning CIC

This pilot will develop new models of long-term condition management to help patients remain independent for longer and have more choice in their end-of-life care. It will create personalised care plans for high-risk individuals and aim to reduce admissions to hospital.

7. Newcastle Hospitals NHS Foundation Trust

This pilot will provide an improved preventative service for over 60s at risk of falling by broadening the current falls and blackout (syncope) service provision. It will enhance provision and access to care and establish a network of community-centred training services led by clinicians, in partnership with the third sector and other agencies. By developing these community services the pilot aims to reduce the number of falls and admissions to hospital.

8. Cornwall & Isles of Scilly PCT

This pilot will unite primary, secondary, health and social care services by setting up a GP-led memory clinic supported by a team of practice-based case managers and dementia care advisers. It will seek to increase the number of people receiving an early diagnosis, reduce admissions to hospital and care homes and see people maintaining independent living for longer.

9. NHS Norfolk and Norfolk County Council

The focus of this pilot will be on integrating care services for the elderly. Joint working between the PCT and the County Council will identify people in need of support and then work with them to develop personalised care plans. It aims to help elderly people live fulfilling and independent lives and to form care plans that meet the needs of both patients and carers.

10. Northumbria Health Care NHS Foundation Trust

This pilot will be exploring a new approach to helping patients with Chronic Obstructive Pulmonary Disease (COPD) to manage their own care. The pilot will ensure providers work together to co-ordinate care, provide consistent information and education and help patients manage their own care (with assistance from their key worker).The pilot aims to increase patient satisfaction, reduce hospital admissions and reduce the length of stay in hospital when admission is required.

11. North Cornwall Practice-Based Commissioning Group

This pilot involves 10 GP practices in North Cornwall working together to integrate Mental Health community teams, based in a rural location, with a single point of access from GP practices. It will integrate Mental Health acute and social services. The pilot will aim to dissolve boundaries so patients can more easily navigate through the system and ensure they ‘only have to tell their story once’.

12. Principia – Partners in Health, Nottinghamshire

This pilot is designed to help create more informed and empowered COPD patients. It will involve partners working together through two projects to identify ‘at risk’ patients, and work with teams in community wards and with other partners involved in COPD treatment to integrate care along the clinical pathway. It is designed to improve co-ordination of care, increase patient satisfaction and reduce hospital admissions.

13. NHS Tameside & Glossop

This pilot will be seeking to change behaviour amongst people at risk of CardioVascular Disease (CVD). It will involve developing partnerships to identify ‘at risk’ residents, supporting them with diagnosis/treatment but also promoting self-care and behaviour change. The aim is to reduce the risk of CVD (and reduce mortality rates for patients who have contracted it), improve the patient experience and reduce visits to Outpatient clinics.

14. Torbay Care Trust

This pilot will be integrating care for the elderly so that it is personalised and tailored to individual needs, secures best possible outcomes and ensures best use of resources. It will involve partner organisations across primary, secondary, social care and mental health services focusing on the whole care pathway, seeking to deliver high-quality, safe, and reliable services for patients across the spectrum of care.

15. Tower Hamlets PCT

This pilot will be helping patients with long-term conditions to manage their own care. It will help patients make their own choices, with support from a range of diverse services and specialists locally. It will aim to improve health and well-being for patients with long-term conditions, increase uptake of services from targeted hard-to-reach groups and reduce the expected trends in long-term conditions.

16. Wakefield Integrated Substance Misuse Service

This pilot will integrate care in the context of a substance misuse and social reintegration service for vulnerable people. It will involve a partnership of NHS, third sector and wider stakeholders and aim to make measurable improvements in the “care experience” for substance misusers, creating integrated pathways that are both personalised and cost efficient.

Pilots welcome as no one model of integrated care will work everywhere

King’s Fund Press Release | date: 01.04.09

Commenting in response to the Department of Health’s announcement today of new pilot schemes trialling the integration of different patient services including health and social care, The King’s Fund’s Chief Executive, Niall Dickson, said:

‘Bringing different services together in this way offers great potential for improving the quality of care patients receive. Too often boundaries between health and social care prevent people getting the care they need. Patients have to find their way around a complex system of doctors, community health workers and social care services when they should be able to talk to a single person about all their care needs. Some patients can end up blocking hospital beds when what’s best for them would be more support at home. And poor co-ordination between health services in the community and hospitals can mean unnecessary admissions and poor aftercare.

‘As more people live with long-term conditions, the challenges posed by chronic disease management and care planning will require services that are able to respond to the range of needs each patient has. Having a clear single point of contact for all services and ensuring better joint working between local health services and local councils should help people manage their conditions more effectively and receive more personal and convenient care.

‘The major challenge will be getting different health professionals – generalists and specialists, social care workers, community and hospital-based staff – to work more closely together. New and better types of care cannot be delivered simply by housing different professionals under one roof or merging multiple organisations. It requires bringing teams together, integrating the way staff work and creating new relationships between organisations.

‘It is also important that we do not create new monopoly organisations around the NHS that deny patients choice – we need services that are responsive and understand that either patients or commissioners may decide to go elsewhere.

‘It’s also important to recognise that there is unlikely to be one model that will work everywhere. That is why these pilots are to be welcomed but it is also why they will need to be thoroughly evaluated. The government has a habit of setting up pilots and then rolling out before lessons are learnt – that must not happen this time. This is a chance to learn genuine lessons about the best way to organise services.’

Notes to editors

  1. For further information or interviews, please contact The King’s Fund press and public affairs office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
  2. The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.
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