Rob De Felice, business development director at IEG4, updates on the ongoing challenge of achieving a much-needed integrated healthcare system.
When the UK Department of Health and Social Care and the NHS first set out plans for an integrated care model in 2013, they claimed: “For health, care, and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carers and family.”
The focus of this was moving away from episodic care to a more holistic approach to health, care and support needs, one that considers the entire individual, including their emotional, social, and psychological well-being in addition to their physical health.
Ten years later, there are now 42 integrated care boards (ICBs) in operation across the country. Yet we are still to see a truly connected process for staff on the ground, and for patients receiving treatment.
Primary, secondary and social care all have a distinct role in the patient pathway when they are living with a serious long-term condition. These services should be interdependent and work in harmony to provide seamless and effective care.
However, the current model is still characterised by fragmented and siloed operations. With some ICBs serving populations of more than three million, gaps in these areas can have far-reaching consequences including miscommunication, and shortfalls in patient management and care.
The introduction of the ICBs structure provides the right foundations for integration, but to achieve truly integrated holistic care, tailored to the unique needs of each patient, there is still a need to apply innovation to create a completely joined-up approach.
Technological enablers
Technology is a critical enabler of integration, it connects health and social care providers, improves interoperability and data sharing supports care coordination, and connects tools that can empower patients.
As Lord Darzi’s independent investigation into the organisation claimed, the NHS is ‘in the foothills of digital transformation.’ He called for a ‘major tilt towards technology to unlock productivity.
With the UK Prime Minister pledging to put this into practice, we are likely to see conversations around NHS innovation shift to areas that assist the integration model and preventative care.
The continuing healthcare process (CHC) is just one spoke on the wheel of holistic integration, but it is a clear example of where there is potential for improvement through digital integration.
The CHC process is designed to offer those eligible with funding and support for ongoing care, but the traditional decision-making process can be slow, admin heavy and confusing for patients and their families.
This can add additional stress and frustration for them at an already challenging time.
Platforms are available that can streamline the complex processes involved in CHC, ensuring that healthcare professionals and patients, have real-time access to essential information.
By digitising workflows and integrating them with existing health and social care systems, we will see enhanced efficiency, reduced administrative burdens, and timely, accurate decision-making.
This enables improved patient outcomes and a more seamless, co-ordinated approach to managing long-term care needs.
Social prescribing is another holistic approach to care that complements the integration of health services. It involves referring patients to non-clinical services to address their social, emotional, and practical needs.
This could be anything from community groups, connecting patients to financial management support, and exercise memberships.
Both examples demonstrate the value of holistic care supporting the benefits of integration.
For example, if a GP or a specialist within a hospital recommends social prescribing services, the symptoms of their condition could be reduced, meaning they are less likely to need to revisit urgent care in the future.
Digital solutions or platforms play a significant role here too; by enabling healthcare professionals to see a patient’s history across all their health service touchpoints and link them to the right service for their needs more easily.
A collaborative culture
Achieving integration requires more than just technological solutions; it necessitates a cultural shift towards collaborative care. Healthcare professionals across primary, secondary, and social care must embrace a team-based approach, recognising the value each sector brings to patient care.
Ongoing training and development are essential to equip healthcare providers with the skills needed to work in an integrated system.
While different systems can work collaboratively in a practical sense, it will take time for a collective shift in mentality away from more traditional siloed ways of working.
While there are digital platforms on the market that allow information sharing between the NHS and social care providers and enable patients to be directed towards holistic care that meets both their medical and social needs – the existence of such platforms won’t work without a team embracing change and with an embedded collaborative culture.
Decision-makers and those in senior leadership must play an active role in the development of such a culture.
That involves developing a collaborative vision, with clear steps to take it forward and excellent communication of the benefits to patients. From there a new mindset will take shape.
Meeting the needs of the population
The population in the UK is growing year on year, with demographic shifts and ever-changing needs. Integrating health services across primary, secondary, and social care is pivotal for sustaining our healthcare service.
Integrated and holistic healthcare really lies in the hands of care providers delivering the initiatives that support every patient in every stage of their care journey and sharing the right information with the right people across the organisation.
But, without technology to facilitate smoother admin operations and promote easier collaboration between all care settings, these initiatives could fail to get off the ground, or patients in desperate need of the services could slip between the cracks.
The journey towards integration is challenging, but it is indispensable to herald in a new era of holistic and integrated healthcare.
