Integrated care systems need to be different - but how exactly?

ICSs are intended to be a fundamental departure from previous NHS structures with a different type of leadership based on partnership, in which local partner organisations hold collective responsibility for resource use and outcomes. However, as ICSs take on statutory responsibilities for the first time later this year (assuming the Heath and Care Bill gains parliamentary approval) there is a risk of recreating established ways of working within the new structures. To live up to their promise, what are the things that should be ‘different’ about ICSs?

First, the concept of equal partnership between the NHS, local government, voluntary sector ...

Integrated care systems are an opportunity to reset the relationship between health services and the public

‘The more we concentrate on merely reworking our existing institutions, the more we fail to see or understand the nature of the new challenges that surround us.’
Hilary Cottam, Radical help

CMMI’s New Comprehensive Primary Care Plus: Its Promise And Missed Opportunities

The Center for Medicare and Medicaid Innovation (CMMI) has recently announced an initiative called Comprehensive Primary Care Plus (CPC+), evolved from the previous Comprehensive Primary Care (CPP) initiative. The initiative mainly consists on paying a fee to those primary care practices willing to introduce organizational changes centered in five primary care functions:  (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and, (5) planned care and population health.

In this post, the authors outline some of the promises and downsides of the PCC+. On the bright side, the authors analyse how financial incentives ...

Can hospital services work in primary care settings?

In this post, the author analyzes how recent changes in primary care in the National Health Services could face the purpose of moving some services from hospital to primary care settings.

The author bases her discussion on a report published by RAND corporation (“Outpatient Services and Primary Care”) that identifies five main areas to be considered when moving services from hospital to primary care:

1. Transfer: The substitution of services delivered by specialists for services delivered by primary care clinicians.
2. Relocation: Shifting the venue of specialist care from hospitals to primary care settings.
3. Liaison: Joint working between specialists and primary care ...

Integrating health care and housing to promote healthy aging.

In recent decades, the influence between health status and social conditions has been broadly studied; one of the conditions that has been strongly linked to health status has been housing.

Population ageing and the increase of chronic conditions are two of the drivers that have made that housing conditions become an important factor influencing health.

Many different proposals have been made regarding home care, most of them trying to take hospital care to patient’s home; in this post, some different aspects are discussed, mainly related to what Medicare could do in order to improve housing conditions and its influence ...

Using patient feedback to drive improvement

Increasing amount of information is being collected from patients after they are discharged in a hospital; this information can be used mainly in three ways: (I) to analyse how care is being performed, (II) to publish data in order to share information with general public and to enhance government’s accountability, and (III) to implement reforms in hospital activities and way of working.

In this post, the author defends the idea that not enough information is being used to make patient experience have actual influence at changing how health care organization work at a local level. Organizational leadership and patient-centered ...

Learning about patients’ experiences of care in their own homes

Patient’s experiences are a main factor in order to design how health care services should work. Many different ways of measuring these experiences have been developed; in this post hosted by the King’s Fund Blog, Jo Maybin explains how they have used face-to-face interviews in patient’s home, what difficulties they have found and what they have been able to investigate thanks to this kind of methodology.

As it is said in the post, patient’s own homes interviews enabled the interviewers to get in contact with external carers, to analyze their point of view in relation to ...

Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes

This guideline offers best practice advice on the care of all people who are using medicines and also those who are receiving suboptimal benefit from medicines, from the point of view of NICE based of the best available evidence.

Medicines prevent, treat or manage many illnesses or conditions and are the most common intervention in healthcare. However, it has been estimated that between 30% and 50% of medicines prescribed for long?term conditions are not taken as intended (World Health Organization 2003). This issue is worsened by the growing number of people with long term conditions (long?term condition is ...

Age UK’s Personalised Integrated Care Programme: where are we now?

Age UK launched its personalised integrated care programme in 2012 in Cornwall. In this post, published in its blog, some data about its evaluation are shown and discussed.

The main objectives of this programme are to improve health and wellbeing of older people by tailoring services to meet their needs, improve the experience and quality of care received, and to reduce unplanned hospital admissions amongst older people with multiple long-term conditions.

The evaluation showed a 31% reduction in all hospital admissions, a 26% reduction in emergency ones, and a 20% improvement in older people’s health and wellbeing. In addition ...

The MDG To SDG Transition: the role of hospitals and integrated primary care.

In 2016, the world will be moving from the Millenium Development Goals (MDG) to the Sustainable Development Goals (SDG). Regarding health-related goals, most of the funding in recent years has been focusing on disease-specific programmes and strengthening primary care; nevertheless, public health, health promotion, prevention, and controlling risk factors through a broad range of policy interventions, both within and outside the health sector, must be an important focus in the era of SDGs.

In this post, integrated health services are seen as a main factor to achieve the health-related topics in the SDGs. The author defends not only strong primary ...