Hertfordshire’s Integration Framework

Featured article - 21 November 2017
Edward Knowles – Assistant Director, Health Integration (West Hertfordshire)

Head-shot of the author, Edward Knowles – Assistant Director, Health Integration (West Hertfordshire)

Integration by 2020 – A Local Approach

Here’s a daunting figure: by the time of the next census in 2021, Hertfordshire's population will have increased by about 11% and the number of people aged over 85 will have increased by 44% - compared to the 2011 figure. And we aim to meet the health and social care demands from our ageing population within the resources we have.

The Better Care Fund is a national initiative to pool existing NHS and social care money in local areas into a single shared fund. Working closely with the NHS, we decide how to spend the budget and develop projects that give people better care services and support. Hertfordshire to date has had one of the largest pooled Better Care Funds in the country and will pool £280m in 2017/18 and 2018/19.

Time for priorities

But ever since the requirement to fully integrate services was announced in the 2015 Government Spending Review we’ve been asking how we can continue to deliver integration at scale and at a decent pace. Over the past few months, health and social care partners from across Hertfordshire have been working together to develop our priorities for the next three years. We want to build on our strong track record of joint working, which over the last year has seen the further development of:

  • New models of support for care homes using learning and development from East and North Hertfordshire’s ‘Enhanced Care in Care Homes’ Vanguard Programme
  • Integrated Discharge Teams based in acute settings
  • Sustained roll-out of integrated community teams to support independence at home.

Our chosen approach is centred on our Joined Up Care Framework (pdf) for Hertfordshire. This uses SCIE’s Integration Scorecard to develop seven standards which we think are necessary to be in place for a truly integrated care system to occur. All our plans are grouped within one of these standards. For example, when making the most of voluntary and community assets (Statement 2, Early Intervention) or with our new Hertfordshire Home Improvement Agency (Statement 3, Value for Money). The statements provide a practical guide for where we want to get to by 2020, as well as a framework for more effectively measuring our joint improvement.

‘I’ statements

Importantly, each standard also has its own patient ‘I’ statement. Statement Five - Integrated Community Care – for, example means ‘I only need to approach one point of contact to get my care needs met’. This reminds us that the person using services remains at the centre of what we do and that integration is the means, rather than the goal, to get there.

It’s a matter of pride that we’ve been able to put this quote on our website from Maurilyn Wild from our Integrated Rapid Response Team: ‘The integrated team has reduced the need for patients having to repeat their stories by sharing information effectively and involving the patients perspective in discussions about their care. We have also been able to prevent hospital admissions in a cost effective way.’

Let’s hope that when the census comes around again we’ll be even closer to providing better integrated services, that offer choice and control, to an increasingly ageing population.

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