Integration health and social care in Hertfordshire

By Iain Macbeath, Director of Health and Community Services, Hertfordshire County Council

Featured article - 30 March 2016

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At SCIE we’re keen on encouraging health and social care integration so that people’s experiences and outcomes can be improved. Here we ask Iain Macbeath to tell us how this is being done in Hertfordshire.

Integrating health and social care might seem a new concept to some, especially perhaps to those outside our sector. In fact, for over ten years we in Hertfordshire have been joining up many services. Let’s discuss why integration is such an important issue for us. But first, I’d like to tell you about two new schemes that are helping us to achieve this at the moment.

HomeFirst brings together expertise from NHS and social care services to support service users in the county. The scheme sees people getting the right care and support; this is provided so that they can stay at home wherever possible. It’s an integrated community service that provides effective care for people at risk of either admission to hospital or being in need of social care. HomeFirst teams include nurses, occupational therapists, social workers and care staff. A multi-disciplinary team.

We have a Rapid Response Service. Both NHS and social care staff start dealing with issues within an hour of hearing about them. (Often the response time is half an hour) But we are also proactive, supporting people who are at risk of unplanned hospital admission. Importantly, a multi-disciplinary meeting - of various professionals like the ones mentioned above – discusses someone’s situation with a view to keeping the person in their own home wherever possible.

We also have the Complex Care Premium, which supports people to continue living in care homes rather than in hospital or being too often involved with emergency GP call-outs. Now, with that scheme in operation, hospitals are discharging people earlier and the needs of the most complex residents at care homes are being met earlier and in a better way.

Why integration’s important

Although the issues of higher demand and bigger financial issues provide fresh challenges, the principles of integration are the same. We don’t just want to make savings and then push problems the way of the NHS. That doesn’t do anyone any good, whether that’s service users or council tax payers. It’s a reciprocal arrangement: NHS staff in Hertfordshire understand the value of working closely with social care.

In the next financial year, we’re going to see pooled budgets locally of £580m, which is one of the largest funds of its kind in the country. This means that, for instance, we’re able to support more people to get the care they want at home. All of this is done so that the outcomes and experiences of people in Hertfordshire are continuingly improved by both the NHS and social care in the county.

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