Tag Archives: integration

The health care industry nationally and internationally is vast and expensive. Insurers and governments worldwide spend a lot of effort seeking to control expenditure growth using rhetoric rather than evidence to improve the efficiency with which health care is delivered. Everybody now believes in “integrated care”. The Americans are obsessed with focusing their reforms on “value” i.e. improvements in the length and quality of life. All funders use the repetition of the religious cant of “prevention is better than cure”. There is agreement that primary care is “important” and should be funded properly. These “ideals” permeate all public and private […]
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Is integration all it’s cracked up to be? A new architecture With the Cities and Local Government Devolution Act receiving royal assent at the beginning of the year, we may be a very big step closer to a new kind of architecture for local government and public services in many parts of the country. With devolution deals working their way through the Treasury pipeline and local political tensions yet to be fully resolved, we are facing a paradoxical situation where things seem to be moving very quickly and yet very slowly at the same time. In Greater Manchester, of course, […]
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In my area of Lewisham, the CCG and local authority have agreed to be a devo pilot. It will result in better services, possibly new powers, more integration. What’s not to like? Devolution has real risks and I’d like to explore them here. And I am not convinced it’s needed at all. Integration, on the other hand, is definitely needed. We know that patients fall through boundary cracks, and communication and culture is often a problem between sectors and organisations. Integration means many things. Including spanning the NHS and social care; primary and secondary care; community care and primary care; […]
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Report on the event we held in Bristol on 8th January: This was the first of a series of meetings to discuss health policy in public. The aim is to explore and fill gaps in SHA and Labour Party health policies. This meeting explored Devolution and its stated aim – integration. In essence it looked at the process of devolution represented by Devo-Manc and the Local Authorities. It did not discuss the pros and cons of devolution of countries, such as Wales or Scotland. It did address the Cities and Local Government Bill. ESSENTIALS Eliminate privatization and the market in […]
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For some time it has been apparent that the second era of the NHS is coming to an end. The era of markets and competition is over. What comes next is up for discussion and the progressive left has to have a narrative. For now the basis of a universal, comprehensive health care system funded out of taxation will remain. The NHS will no longer be truly national and it will somehow be melded with a means tested social care approach. How Public Health gets into the picture and how the whole links to other parts of the public sector […]
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Integration and flexibility: those appear to be the watchwords of a new consensus that is emerging about the future of the NHS. They were the key words that appeared in the Lib Dem public services policy in 2014.  They are also the words that Andy Burnham uses to describe his commitment to a new NHS.  They are also the words used by Lib Dem health minister Norman Lamb to describe his policy at the Department of Health. Lamb’s approach has meant in practice a major handbrake turn for the policies pursued by Conservative ministers at the beginning of the coalition. […]
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There are few areas where the health and social care system can make a bigger difference than in supporting young people with mental health and emotional difficulties. On the latest count nearly 10% of children and young people will experience a diagnosable mental health problem and yet we only spend £0.7 billion or 6% of the NHS mental health budget on this area of care. If we get it right in providing young people the help they need we can make a difference to their immediate distress and that of their families. We can also increase the chance that they […]
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Baseline integration                  At last the government seems serious about pushing for health and social care integration in England. Integrated Care and Support: Our Shared Commitment[1], backed by a collaboration of national partners outlines a 5 year road map and pioneer areas are now beings selected. Integration will take place at a number of linked levels from overall macro commissioning, through workforce development and quality assurance to service redesign and the integration of services around the needs of individuals. The baseline for integration will incorporate a range of changes including: Alignment – where […]
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In a recent Progress blog Andy Burnham set out how, under Labour, the NHS would provide a single service for the whole person, meeting physical, mental and social needs together. Ed Miliband, in his Hugo Young lecture, committed Labour to a radical reshaping of services so that local communities can come together and make the decisions that matter to them. Whole person healthcare and bringing communities together are inextricably linked: indeed, some 60% of the beneficial impact on health is accounted for by the ‘social determinants’, such as jobs, housing, education, lifestyle and local conditions. All the other services – […]
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These are the recommendations of the Independent Commission on Whole-Person Care commissioned by Andy Burnham to make recommendations about how we can integrate health and care services within existing resources, and without another reorganisation. The final report, which can be downloaded here, sets out a blueprint for bringing our health and care services into the 21st Century. The provision of care 1.1 A new government in 2015 must outline expectations and milestones for the growth of new forms of coordinated provision. Local flexibility in the development of new provider models must be encouraged by Government so that different integrated models […]
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The Independent Commission on Whole Person Care was launched in April 2013 by Ed Miliband, Andy Burnham and Liz Kendall MPs to help inform Labour’s Health and Care Policy Review. Sir John Oldham CBE, one of the country’s leading experts on integrated care, was asked to chair the Commission and appointed a group of experts to work with him to produce effective proposals on how Labour’s vision of whole person care can be achieved in practice. The Commission will draw from the findings of the listening exercise shadow health team carried out in spring and summer of this year, the […]
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This morning I was sitting with another ten patients in my GP practice when a very agitated young man in a hoody came in shouting and demanding to see a Doctor. He accused the Receptionists of taking him ‘for a ride’ of ignoring him on the phone for 20 minutes at 10p a minute. As it happened one of the partners came past the desk. The young man now screamed at him: I need to talk to you, he grabbed the Doctor’s shirt. The situation could have gotten very ugly, Police, custody the lot… As it happens this Doctor is […]
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