It has long been acknowledged that health, social care and community (voluntary) services should be much better aligned and integrated to efficiently provide high quality, seamless and person-centred care to people who are most in need. Many integrated care models around the world provide good evidence of such approach making a real difference in people’s quality of life.
Integrated Care Systems
Over the past decades, various government and local efforts have been made to achieve better co-ordination between health and care services in England but results have been limited and progress has been patchy. Although, the recent publication of NHS Long Term Plan (LTP) has truly committed resources to abolish the divide between primary and community services, the development of Integrated Care Systems (ICSs) require a much wider integration and co-ordination across multiple public, voluntary and community services. Most of all it would require collaboration between system stakeholders at an unprecedented level.
We are moving away from hospital-based care and trying to create a shift towards providing more care services in the community, with focus on integrated care systems on a strategic level by 2021 and Primary Care Networks (PCNs) on a delivery scale by 2020.
Primary care networks not only need to develop and mature themselves but would also need to develop system partnerships to enable delivery of truly person-centred care for their local population. The significant responsibilities to be exercised by PCNs in respect of high-quality service delivery, data sharing, recruitment of staff, financial management, liabilities and governance mean that PCNs will need considerable external support in addition to the support from their local health and care system. Community services will need to be aligned with each PCN locally, which could require pathway re-design and re-allocation of existing resources. Digital technology and estates will have to be explored and maximised respectively. Acute services will have to be delivered in a way, intrinsically linked with primary and community services. Social care will have to be closely aligned with health services to provide comprehensive seamless care for local population and the extraordinary potential in voluntary and community services will have to be unlocked to boost the prevention and self-care agenda. National strategies need to be localised and delivery frameworks developed to provide structure and direction on a local level.
Understanding local population on a micro level is key to all this. Not just the health and social care metrics, but demographics and socio-economic factors as well, allowing for flexible allocation of health and care resources on local need basis.
All of the above, generally pans across various strategies, boards, programmes and organisations. To ensure that no aspect is considered or developed in isolation is no small ask.
Now, more than ever, health and social care need to tap into delivery focused brilliant minds to accelerate and enable such change in a short period of time. Our health and care sector is enriched with such minds, evidenced by various systems across England. However, with an ever-increasing workload under matrix management structures, individual’s capacity has become a real issue. Staff are working long hours, simultaneously dealing with multiple deadlines and conflicting priorities, while building new relationships, solidifying existing ones and creating yet more capacity to solve complex problems in a short period of time; multi-dimensional problems that go beyond traditional organisational boundaries. All this in the context of reducing budgets and periodic organisational re-structuring, while keeping focus on the only reason for all this; to provide better comprehensive integrated care for people.
The right individual
To achieve such an ambition in a fast-changing landscape, health and care sector should consider supplementing management staff with experienced and skilful individuals who not only ensure delivery but do so by bringing people together, provide guidance and support where required and ensure sustainability beyond their engagement. Individuals who fully understand the complexities and intricacies of our health and care sector yet think differently; are dedicated and passionate about the reasons for change, can hit the ground running in providing support, are innovative with complex problem-solving skills and most of all, can take accountability of delivery.
The right individual for a limited period of time can not only enhance the quality and delivery of a given programme but can also provide crucial momentum to other dependent programmes; provide greater value for money by delivering outcomes beyond expectations in a short period of time; enrich the discussions around the development of integrated care systems; provide management with much needed support; provide crucial leadership and raise a team’s basic skill level, creating a sustainability beyond his/her engagement.
Key words: The right individual, limited period of time
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