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INTEGRATED CARE
Bridging the divide between primary and secondary care
Chris Hopson, chief executive of the Foundation Trust Network, and Rick Stern, chief executive of the NHS Alliance, discuss how the two organisations have collaborated in an effort explore what ‘optimally’ integrated care could look like in the future. David Stevenson reports.
NHS
England boss Simon Stevens recently stated that it is
“perfectly possible” to improve and sustain the NHS over the next five years in a way that the public and patients want. But to secure that future the NHS needs to change substantially.
At the launch of the ‘Five Year Forward View’ he highlighted a number of actions that need to be taken. These include the need to break down the boundaries between family doctors and hospitals, between physical and mental health and between health and social care.
Stevens noted that the Forward View is not a blueprint for care throughout the entire country, adding: “England is too big for a one-size-fits-all plan, and nor is the answer to simply let ‘a thousand flowers bloom’. It’s horses for courses.”
This is also the view taken by the Foundation Trust Network [soon to be NHS Providers] and NHS Alliance, which partnered to explore how new models of integrated care can be delivered – bridging the artificial divide between primary and secondary care.
The two national organisations aim to bring together senior leaders from primary care and secondary care to discuss difficult challenges and identify shared solutions. They also aim to facilitate the sharing of good practice particularly showcasing case studies where colleagues from across the divide are working closely together to improve communication between professionals, and streamline pathways for patients.
48 | national health executive Nov/Dec 14 Holding up the mirror
Chris Hopson, chief executive of the FTN, told NHE: “One of the key leaps forward, which both our organisations agree very strongly on, is that integrated care really is important and that it is about local people making decisions about what the best local model for them is.
“At the moment there is a bit of a ‘strategic ferment’ in terms of people really thinking about the challenges of integration. People know that the existing model, in the long- term, won’t work, and we know we need to do something different, but we’re not quite sure what.
“One of the clever things we can do, as national organisations, is to hold up the mirror to various places that are perhaps slightly more advanced in answering the questions of how might we do this. There is some really interesting stuff going on but across healthcare we’re not very good at playing that back to people and enabling them to pick up on the experience that is being developed elsewhere.”
In symphony
FTN and NHS Alliance are due to release their first report, which will highlight examples of best practice and how some primary and secondary care providers are getting “braver” and more “creative” in how they intend to deliver integrated care.
One such example is the Symphony Project, an innovative, evidence-based integrated care
programme which aims to improve the way in which health and social care is delivered in South Somerset.
Symphony’s aim is to establish much greater collaboration between primary, community, acute and social care, particularly for people with complex conditions.
There is a well-established Symphony Board including Somerset CCG, Somerset County Council, Somerset Partnership NHS Foundation Trust, Yeovil District Hospital NHS Foundation Trust and others, chaired by a GP on the CCG’s governing body.
All the partners have contributed £27,000 to a shared project budget and by using an alliance contracting model they aim to spread the risk and share any gains between all providers. The initial plans are to start small, focusing on a cohort of the sickest patients within South Somerset (population 164,000), but the ambitions are to roll it out across the county.
Rick Stern, chief executive of the NHS Alliance, said: “We’ve been looking for examples of good practice where people are working really effectively across the system and we’re going to pull some of that together in our upcoming paper which will express, in more detail, how we think we can help support the system in better ways by having joined-up conversations.”
After hosting a number of working sessions earlier this year, both chief executives stated that it was interesting to see that when clinicians were put together in the same room
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