What is the Integrated Care Pilot?

At its best, our health and social care system provides people with timely, effective access to high quality patient care that makes a real difference to their lives.

That said, the way health and social care services have developed over the last 60 years means that patients can sometimes end up feeling ‘passed around’ the system, as they come into contact with different teams and because they have to go to different places for different appointments, tests or treatment.

Our Integrated Care Pilot involves looking at how we can organise the system of care more effectively so that patients get the best service possible and that we make most effective use of the resources available to us. This is about designing services which fit around the needs of patients, rather than expecting patients to fit around the way that services are organised. It is also about making sure that all aspects of the system – from IT to finance  - help staff  work together across the organisations providing care.

Who is involved?

 The Pilot involves staff across King’s Health Partners, working in partnership with GPs and other health and social care services in Lambeth and Southwark. We have been discussing the Integrated Care Pilot with these groups for some time and want to work with them to understand how they think systems and services could be improved.

What does it involve?

 In the first instance, we are looking the way care is provided in three areas to see how we can improve things: frail older people; urgent care; and long-term conditions such as chronic obstructive pulmonary disease (COPD) and severe mental illness.

We want to design the system in a way that allows all of the health and social care professionals involved in providing services in these areas to work as effectively together as possible. This is based on the principle that organisational boundaries should not get in the way of providing people with the best possible care in the right place and at the right time. This will mean looking at all aspects of the system – from technology and how information is shared, to finance and understanding the way in which care is funded.

We are in the process of setting up ‘expert groups’ made up of professionals, patients and researchers who will help us decide how best to organise systems of care more effectively in future.

Shouldn’t we concentrate on improving the quality of patient care rather than the organisational mechanics of how it is provided?

 Improving patient care and the way it is provided go hand in hand. Moreover, it isn’t an option for us to simply continue providing services in the same way as we have done in the past. Factors such as the ageing population and wider financial climate mean that we have to improve the way we make use of the resources available to us.

Whilst this is a huge challenge, it is also an opportunity to think creatively and differently about how we can work together across the health and social care system to provide the best possible care.

How will patients benefit?

Our overall aim is to help people live healthier lives with fewer health emergencies. This will mean different services across the health and social care system working together to identify risks to people’s health and to support them in managing them and to respond quickly when emergencies do arise.

If this is such a good idea then why hasn’t it been done before now?

 There are some good examples of the NHS working effectively with social care, primary care and the voluntary sector. The Integrated Care Pilot is about looking at how we can do this more systematically and in a way that makes sense in Lambeth and Southwark.

One of the reasons we established King’s Health Partners Academic Health Sciences Centre was to bring physical and mental health services more closely together. This provides us with a good platform to work with our partners to explore how the whole system could work more effectively.

Who is paying for the pilot?

NHS London has provided funding of £250K to each of the three Academic Health Sciences Centres in London to work with local partners and develop proposals. In addition King’s Health Partners has received a further £250K to undertake the work from the Guy’s and St Thomas’ Charity.

What are the governance arrangements?

 A Programme Board has been set up to oversee the pilot. The Board has been meeting regularly and is co-chaired by Stuart Bell, Chief Executive of South London and Maudsley NHS Foundation Trust and doctors Adrian McLachlan and Femi Osonuga, the nominated GP leads for Lambeth and Southwark.

What is the timeline for the pilot?

The Pilot is already underway and we have started preparatory work on our first priority area - improving systems for frail older people. We will be looking in detail at how services for this group of people are provided and used. In particular, we will concentrate on ways in which we can prevent frail older people being admitted into hospital when it is avoidable. The Programme Board is also working on the design and set up of the other areas of the pilot and will develop a detailed business case over the summer of 2011.

To find out more or get involved in the Integrated Care Pilot please contact Jim Lusby on j.lusby@nhs.net.