How can we create a more integrated service?

Dr Robert Varnam, who is jointly leading the NHS Future Forum’s work on integrated services, reports on how it is focusing on the practical issues of creating a more integrated experience for patients, particularly for three specific groups.

Well, things have been very busy since we launched Phase 2 and the Integration workstream.

We have an excellent team with a wide range of backgrounds and experience.  I’m particularly pleased that there’s such depth of expertise in understanding and serving the needs of patients, carers and the wider public, and of delivering innovative solutions to complex problems.

At our first team meeting, we agreed to focus on practical issues of how policymakers, leaders and staff can collaborate to create a more integrated experience for patients.  We’re particularly interested in how the needs of three groups can be better met by the health and social care system:

  • the frail elderly with multiple long term conditions
  • children with complex needs
  • adults with long term mental health problems.

The government has now launched the process for engaging with the public and professionals to inform the development of next year’s social care White Paper.  We’re pleased to be able to feed our learning into that process.

We have already begun holding listening events around the country, many hosted by organisations who are already making great strides towards delivering integrated care.  At each event, we’re asking the same questions about how to achieve success in this area:

  • What are the problems integration can solve?
  • What are the examples of success and challenge we should be learning from?
  • What factors contribute to success in improving integration?
  • What factors block successful integration?
  • Who needs to do what next to enable integration to be progressed in a pragmatic and achievable way?

Please do contact us at with your own experience, or leave your comments below.

In Conversations, NHS Future Forum, Robert Varnam | Tagged , , ,

5 Responses to How can we create a more integrated service?

  1. Dr Stephen Searle says:

    As Vice Chair of the Staffordshire Neurological Alliance I have become aware that only about 10% of patients with neurological conditions are members of relevant support charities such as Parkinsons UK, MS society and MND Association. The Alliance is increasingly aware of its signposting role in directing individuals to the help and support they require particularly at the time of diagnosis when people are often left in limbo, as are their carers and relatives.
    We undertook a quality neurology audit which revealed large gaps in the joined up nature of services and are working with interested parties in Staffordshire to try and improve this. The condition specific charities can also provide training for GP practices on the nature and availability of support and information.
    If you would like to know more about our work please email me.

  2. Catherine Gleeson says:

    I totally agree that condition-specific organisations are important. They could be used much more widely as part of staff training around sources of support and information for patients and families. They also provide great ‘listening opportunities’ for staff wanting to find out patient’s experiences of services. At a recent Breathe Easy group (patient support group of British Lung Foundation’ it emerged that patients are not aware of the clinical qualifications of Practice Nurses carrying out annual reviews for COPD. This information should be documented in GP Practice leaflets so that patients can be confident that the nurse doing reviews for long-term conditions such as COPD have got the necessary qualifications.

  3. you are invited to join the the health intelligence tools network on nhs networks (serach for it on – one of the offerings is a tool which:

    The data data must be integrated and as an an anlayst I would suggest that the most efficient way of doing this is with the NHS Patient Pathway.

  4. tony chandler says:

    Staff play a critical role in the delivery of more seamless care- designed around the patient pathway. Assistant Practitioner roles at Band 4 in particular can bring noticeable improvements to care outcomes. A case study soon to be published by Skills for Health about the experience of assistant practitioner roles within one large acute Trust in London, gives some evidence about how more generic roles can create more seamless care and improve the patient experience. In care of the elderly a band 4 role called the rehabilitation assistant practitioner has made an impact.The role has some physiotherapy, occupational therapy, nursing and podiatry competences within it. There are many more such roles being developed across the country and it would be very good to build on mapping done already by Skills for Health and have a substantial study measuring the impact of these new roles on care outcomes.

  5. Robert Varnam says:

    Thanks to everyone who joined our web chat this evening about integration. The recording is available at

    Please do keep your ideas and experiences coming in. Our email is

    We’ve gathered lots of information and views already about how to make integration easier for everyone, but we’re keen to reflect as wide a range of ideas and views as possible in our report, which is due in early December.