The future of integrated care in England. Health leaders’ views on how to make system working a success

For decades, the legislative framework governing health and care in England has centred around the principle of competition between organisations to improve the quality of services. Yet there is now wide recognition that we need to look to collaboration and integration to improve population health, deliver better quality care, and make more efficient use of resources. 

The NHS Confederation welcomes this move, the importance of which is further reinforced by experiences of coping with a pandemic. While COVID-19 has proven to be the greatest challenge that NHS and local government services have faced in their history, it has also demonstrated what can be achieved when we move away from individual organisations working in silos and towards true collaborative working within systems. 

Over the coming 12 months, the government is expected to table new primary NHS legislation that will set out a legal framework through which NHS organisations will continue to ...

Integrated Health Service Delivery Networks (IHSDN) based on primary health care (PHC)

Integrated Health Service Delivery Networks (IHSDN) based on primary health care (PHC) are the most promising solution for health systems to satisfy the health needs of the population and to address access, efficiency, quality and equity challenges faced by health systems of the world. PHCs essential attributes (people and family centred care, comprehensiveness, continuity, longitudinality) position this approach as one of the key strategies for countries to meet the aspiration of achieving universal health coverage.

Creating care networks has been a common thread running through Latin America and the Caribbean health policy agendas. In terms of actually putting the IHSDN model in action, there is a wide range of interpretations and experiences, with designs, scales, organizational methods, and maturity levels that vary within and between countries.

Health Network in Action, a publication from the Inter-American Development Bank, shares evidence of the progress made in forming and launching IHSDN in Latin ...

Health Networks in Action: The experiences of Argentina, Brazil, Colombia and Mexico

Dioselina is a 54-year-old divorcée who has no children and lives alone in a large city. She has been unemployed for a year and just started receiving welfare six months ago. As for her health, she has long-term obesity, chronic obstructive pulmonary disease, and diabetes. In recent months, she began to develop foot ulcers because her blood sugar was not being monitored properly, which is attributable in part to difficulty accessing healthcare services and getting medications and lab tests. If she does not receive rapid treatment and more specialized care for the ulcers, they could worsen and require hospitalization.

A growing number of people who seek health care have stories like Dioselina’s. Healthcare systems in Latin America and the Caribbean face significant health challenges affecting all age groups, which cause premature death and take a heavy social and economic toll.

Taking cues from the Declaration of Astana, nations ...

Communication Heal? Examining the Role of Patient Satisfaction and Communication Experience in China

China is facing the problem of having health care that is difficult to access. Online patient–provider communication (OPPC) may bring a new option to deliver health services. However, online communication with doctors is still novel to many people in China. Little research has been conducted to examine how OPPC could improve health outcomes. With an integrated model that incorporates social cognitive theory into the three-stage model of health promotion using interactive media, this study tested the social mechanism underlying the impact of OPPC

Does Scale of Public Hospitals Affect Bargaining Power? Evidence From Japan

Many of public hospitals in Japan have had a deficit for a long time. Japanese local governments have been encouraging public hospitals to use group purchasing of drugs to benefit from the economies of scale, and increase their bargaining power for obtaining discounts in drug purchasing, thus improving their financial situation. In this study, they empirically investigate whether or not the scale of public hospitals actually affects their bargaining power. 

A Digital NHS? An introduction to the digital agenda and plans for implementation

WHO: What is people-centred care?

Globally, 1 in 20 people still lacks access to essential health services that could be delivered at a local clinic instead of a hospital. And where services are accessible, they are often fragmented and of poor quality. WHO is supporting countries to progress towards universal health coverage by designing health systems around the needs of people instead of diseases and health institutions, so that everyone gets the right care, at the right time, in the right place.

WHO: What is people-centred care?

Globally, 1 in 20 people still lacks access to essential health services that could be delivered at a local clinic instead of a hospital. And where services are accessible, they are often fragmented and of poor quality. WHO is supporting countries to progress towards universal health coverage by designing health systems around the needs of people instead of diseases and health institutions, so that everyone gets the right care, at the right time, in the right place.

Meeting the Needs of the Growing Very Old Population: Policy Implications for a Global Challenge

Very old adults are one of the fastest-growing age groups worldwide. Yet they rarely constitute a targeted group for public policies. Drawing on the results of the centenarian studies presented in this special issue, we highlight major challenges that arise from the increase of this population. We outline several promising approaches for policy makers and professionals to develop evidence-based policies and programs that are tailored to the needs of very old adults and their families. We focus our discussion on three key topics essential to life care: the importance of integrated care to meet the complex care needs of the very old; the balance between formal and informal care; and the development of suitable places for living. Besides more specific measures, we propose that policies promoting the social integration of very old adults in their communities would be particularly helpful, as these may benefit not only the very old and ...

Person-centred care in Europe: a cross-country comparison of health system performance, strategies and structures

In February 2016, the international charity Picker Institute Europe published a policy briefing titled “Person-centred care in Europe: a cross-country comparison of health system performance, strategies and structures”. The document provides an overview of policy and practice relating to person-centred care in England, Italy, Spain, Germany and the Netherlands. The briefing focuses on both quality and efficiency of care and highlights recent innovations and adaptations driven by the rise of noncommunicable diseases and financial challenges. For example, in the Netherlands, models of care have shifted towards both prevention and an increased usage of primary care for handling patients with chronic conditions. In Spain, basic primary care services are available within a 15-minute radius of any place of residence. Moreover,  patients who have received specialist care are referred back to their primary care doctor, who has a comprehensive view of the patient based on the full medical history.  This makes care ...