Activities to achieve integrated care
The activities of integrated care describe the interventions and practice-focused approaches that deliver person-centred coordinated care.
They range from proactive and preventive management of care needs to effective behaviours of multidisciplinary teams, joint care plans, community-based services and care support in crisis and during transitions.
-
Prevention and self-care
Enabling people to maintain or regain independence and improve their quality of life
-
Multidisciplinary teams
Bringing together the expertise and skills of different professionals to assess, plan and manage care jointly
-
Assessment and care planning
Multidisciplinary teams working with people who use services and their carers to produce joint needs assessments
-
Community-based integrated services
Enabling people to receive care closer to home, with services focused on keeping them well
-
Care and support in crisis
Providing timely access to advice and treatment to prevent an escalation of needs that require emergency care
-
Transitions of
care
Smooth transitions of care ensuring people receive the support they require in the right place and at the right time