Integration: it’s really happening, and in a place near you

By Debbie Sorkin, National Director of Systems Leadership at The Leadership Centre

Featured article – 7 October 2015

Photo of Debbie Sorkin

It’s what we all want, isn't it? Fewer presentations at A&E, more people getting care and support in their own homes, a drop in alcohol-related incidents and a fall in the number of children going into care as a result. These types of things are actually happening in places around the country, and at a time when there are so many stories of gloom and doom around health and social care, they deserve to be recognised and celebrated.

In Plymouth, for instance, a national Systems Leadership programme has been supporting the development and implementation of a Strategic Alcohol Plan for the city, working with people across health, social care and the local council. The issue for Plymouth has been how to reduce alcohol abuse whilst not damaging the city’s economy. People have come together and identified common aims and goals, to be realised in four ways: treat, protect, prevent, and control.

Outcomes have included measurable reductions in alcohol-related hospital admissions, and a fall in the number of children going into foster care as a result of parents having alcohol problems. Plymouth has done this by taking a whole-systems approach, looking at a range of issues and putting integrated packages of care into place to support people and pre-empt the kind of crises that lead to A&E in the first place.

Further north, in Dudley, taking a Systems approach to delivering more healthcare at community level has meant the introduction of GP-led multi-disciplinary teams, including community nurses, mental health workers, pharmacists and social care link workers. Local voluntary and community services are also playing a central role in delivering integrated care. Reports from GP surgeries suggest that this is leading to a reduction in demand for medical care and more emphasis on links across the community.

Across the way in Shropshire, Karen George, a lead nurse in an NHS community trust, is making a real impact. Karen is funded through her CCG to go into care homes and home care services and train social care staff, not least in spotting early signs of deterioration so that people can be treated before things get serious, and out of hospital where possible.

Similarly, The Royal Masonic Benevolent Institution (RMBI), in its homes in Leicester, is working closely with local GPs to get advanced agreed plans of care in place to help prevent hospital admissions. In Porthcawl, the RMBI is piloting a scheme with the NHS in Wales to help reduce unnecessary hospital admissions out of hours, as this is often when people are sent to A&E by covering GPs. They connect directly with a central hospital, where a consultant sees the person via video link and have access to their observations. They can then decide whether they do, in fact, need hospital treatment or whether they can remain in the home with appropriate care.

All of these are examples of health and social care working together, taking a systems approach, working through problems and coming out with solutions. If you want to do something positive rather than playing the blame game, it’s worth looking at what’s going on out there. If you’re interested, do get in touch: debbie.sorkin@localleadership.gov.uk.

Debbie Sorkin oversees the national Systems Leadership programme.

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