Integrated care

The White Paper demonstrates the government’s commitment to integrated care – care that is co-ordinated, continuous and person-centred.

Organising care around people’s needs

Organising care seamlessly around the needs of people is central to improving the experience for those who use our health and care services. National Voices, the coalition of health and social care charities, has told us that ‘the lack of joined up care is the biggest frustration for patients, service users and carers’. We want to avoid people feeling bounced around the system, having to tell their story several different times and experiencing unnecessary delays.

One of the key conclusions from our national ‘Caring for our future’ engagement with the NHS Future Forum, and the forum’s report on integration, is that services and professionals should focus on the individual, not just their condition. The government is supporting all of the NHS Future Forum’s recommendations on integrated care and is committed to taking integrated care further.

In the new legal framework, set out in the draft Care and Support Bill, each local authority in England will be required to make sure its own adults, children and housing departments work together, and to integrate services with health and health-related services locally.

Investment

We are committed to investing in integration to help us achieve our ambition of everyone experiencing organised, effective and joined up services. The health system will transfer a further £100 million and £200 million in 2013-2014 and 2014-2015, on top of the £2.7 billion transfer to local authorities that was announced in the last Spending Review.

This new funding will further support local areas to deliver social care services that benefit people’s health and wellbeing, by promoting more joint working between health and care. This will enable local areas to transform their services and to deliver better integrated care that saves money across the two systems: for example by supporting people to maintain their independence in the community for as long as possible.

Framework

Later this year, the government will publish a framework, coproduced with partners across the new health and care system, including the NHS Commissioning Board, Monitor, local government, patients, people who use services and carers. It will help to remove the barriers to evidence-based integrated care and support becoming the norm over the next 5 years. This will include developing proposals on the following areas.

Measuring people’s experience of integrated care

As recommended by the NHS Future Forum, we will put in place better ways to measure and understand people’s experiences and views of integrated care. We will use that information to set a clear, ambitious and measurable goal that will improve people’s experiences.

Sharing the tools and innovations that promote integrated care

There are a number of existing models of integrated care that can serve as examples to others. We will establish a collaborative network of national partners to share best practice in a simple and accessible way, and also share practical tools that can be tailored for local use, such as model contracts and support for pooled budget arrangements.

Aligning incentives

We will develop new payment mechanisms to promote better integrated care. An example of these includes ‘year of care’ tariffs, which give patients and people who use services greater flexibility about how they manage long term conditions, such as cystic fibrosis, a mental health condition or complex, multiple conditions. We will explore how these new payment systems can be further developed to support integrated care. This will include looking at how improved incentives can reduce delays in discharge from hospital.

Developing models of co-ordinated care for older people

The NHS Future Forum identified particular groups who would particularly benefit from integrated approaches to commissioning and delivering services. We will pursue the development and piloting of contracts covering all health and care and support needs for older people.

Sharing information

We will set out our plan for improving the sharing of people’s personal information, assessments of need, and care plans, across organisational and professional boundaries to provide a more joined up service, as described in Department of Health’s recently published Information Strategy.

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