Making a difference with integrated care

Featured article - 26 July 2018
Lesley Jeavons, Director of Integration, Durham Dales, Easington and Sedgefield Clinical Commissioning Group

It’s fair to say that when I took up post as Director of Integration in January 2017 I was already more than familiar with the benefits and challenges of delivering public services in partnership with everything that collaborative working brings.

We have a tradition in County Durham of developing and maintaining robust partnerships and integrated models, the first integrated multi-agency team having been developed in 1998.

What’s different about the new County Durham Integrated Care Partnership (ICP) is that it puts people and patients at the centre of our efforts with services and teams being “wrapped around” groups of GP practices. The 13 Teams around Patients (TAPs), serve a population size of between 30-50,000 and are comprised of nurses, therapists, social workers and other services who deliver therapeutic interventions for older people and those with long term conditions. Our ultimate aim is to provide proactive care which promotes independence and prevents further deterioration in a person’s health and wellbeing and by doing so avoids admissions to acute and/or long term care settings.

• SCIE report. Delivering integrated care: the role of the multidisciplinary team

“Nothing new there!” I hear you cry.

Well, previous iterations of integration across County Durham, whilst successful, have in the main been between the big providers e.g. Councils with Foundation Trusts, providing services aligned to intermediate care and learning disabilities/mental health services with Primary Care on the periphery of the model.

By centring the model around Primary Care we have created a clinical leadership model which not only draws upon both the generalist and specialist skills of clinicians but it has pioneered new ways of working between the NHS, adult social care and the voluntary sector.

It hasn’t been easy and we still have a way to go but we are now seeing benefits including a sense of enthusiasm from clinicians to work in partnership and engage in real life place shaping, so enhancing their local service offer.

The progress we have made to date includes an emphasis for all partners to see unnecessary admission to hospitals as a failure of ‘our system’. Real ownership of admission prevention and effective discharge has been achieved not just across the NHS but adult social care; similarly partners are working together to address issues such as nursing recruitment and enhancing the urgent and emergency care offer as opposed to only addressing the wicked issues that exist within their own organisations.

I am confident that we will go from strength to strength as our ICP has real ambition. Our challenge will be to deliver our objectives at a time where significant pressure is being placed upon every part of the system. We will however be focussing on real changes to service delivery, by delivering a higher proportion of care at home or closer to home and improving population health. However we know that will also require the Government and national bodies to give the same attention to community services as they have given to acute hospital services in previous years.

• Twitter: @DDESCCG