Integrated working is a coordinated, person-centred concept of care. Being person-centred allows the quality of care being delivered to be at an excellent quality. This is because the care remains tailored to the needs and preferences of the individual. Additionally Integrated working steers away from the episodic care and allows a more holistic view on an individual, in regards to their healthcare and support requirements. To achieve this individual care there are many aspects that allow health and social sectors to work together to support a person.
Shared care plans is one of these aspects as this allows everyone involved with the care to all have access to their personal care plan. This allows the service user not to repeat themselves to different individuals. Furthermore, integrated working is primarily preventative care as an aspect of it is to have a key worker who is the main point of contact in emergencies. Which means there would be a decrease in hospital admissions, as there would be planned care and more contact to prevent these situations.
National Voices a national coalition of health and care charities, believes that the lack of integrated care is a huge frustration for service users and believe that ‘achieving integrated care would be the biggest contribution that health and social care services could make to improving quality and safety. ‘ (National Voices 2011) Many features of integrated care support this statement such as within an integrated way of working individuals come to a decision promptly.
In addition to this, the individuals involved in the service user’s care can share a budget to ensure that they can offer all the support that the individual may require. Furthermore, with integrated care being preventive and decreasing the amount of hospital admissions one individual has then this may suggest that there is a chance of this being financially efficient. Another positive aspect of integrated care is allowing an individual to take control over their personal care. This is a way of promoting independence and empowering the individual and focus on community resilience by taking charge of their own wellbeing.
Without integration at various levels [of health systems], all aspects of health care performance can suffer. Patients get lost, needed services fail to be delivered, or are delayed, quality and patient satisfaction decline, and the potential for cost-effectiveness diminishes. ‘ (Kodner and Spreeuwenbur, 2002, p2) In contrast to this, there are some concerns that injecting competition into services funded in the NHS may prevent effective integration. Which may result in fragmentation, which could lead to severe consequences for patients especially if their care is urgent or complex.
Further disadvantages of having integrated care is the risk of confidentiality being broken or if the records are accessible online, the service may go down restricting everyone having access. In regards of key worker as the main point of contact, this would not be practical is integrated care was available for everyone as more staff would be required to become key workers which would not be cost effective and also workloads would increase due to the need to support every individual.
Integrated care works with key care groups such as older people, individuals with chronic disease, individuals living with multiple health and social needs, individuals with urgent or medically complex conditions also there is a possibility for integrated care for end of life. Torbay Care Trust is an example where integrated care has worked for older people. Torbay care has integrated teams, which serve a neighbourhood of between 25,000 and 40,000 and has connections with the general practices in the neighbourhood.
They combined budgets, which allowed them to arrange and fund services that were required specifically to the individuals. Additionally their main priority was to increase spending on transitional care services that enable the elderly to be supported at home and to prevent unnecessary hospital admissions. Since 2007, Torbay Care Trust has been “financially responsible for 144 fewer people aged over 65 in residential and nursing homes, with a corresponding increase in home care services targeted at prevention and lowlevel support. (Thistlethwaite 2011). In regards to integrated care for individuals with a chronic, disease Oldham’s Pennine Musculoskeletal provides an integrated team in Rheumatology and orthopaedics, and chronic pain, which consists of consultant rheumatologists.
The team employs a clinical assessment nurse and specialist rheumatology nurses, physiologists, occupational therapists, orthopaedic consultants, liaison psychiatrists, and podiatric surgeons. Pennine MSK is able to triage patients within 24 hours, has low waiting times for assessment (over 80 per cent now within one to three weeks), and most patients are seen and discharged from the service within seven weeks. ” (Pennine Partnership MSK Ltd 2011) In November 2013 14 neighbourhoods in the UK were chosen by the government to become a pioneer in the new model of care ‘integra ated care’ Southend was selected their main aim was to see how more support could be delivered at home and to find ways of developing innovative ways to coordinated care so it was person centred.
The scheme brought together a collective resource of Southend’s “statutory, voluntary, and third sector organisations. ” (CCG, 2015) This allowed Southend to have an integrated health and social care system, which meant that information was shared between professional which ensured that they could create a personal care plan encapsulating all of the service user’s needs. Integrated care receives funding such as the Better Care Fund, which is government funded, the fund put into place in June 2013 to ensure a transformation in integrated health and social care.
A single budget is to support health and social care services, and allow them to work together in local areas. The fund does not only bring the local resources together with the NHS it provides an opportunity to improve services and be cost effective. The fund itself does not report the pressures financially faced by local authorities and CCGs, but it does act as a facilitator for a collective approach to delivering good quality services and priorities.
