The NHS and Integrated Care Systems
A lack of integration in our health and care system has remained a challenge since the inception of the NHS. Structural divisions between care settings, have resulted in a lack of coordination and collaboration between providers and those commissioning services.
This has led to:
- Duplication of effort across individual health and care organisations.
- Patients falling between organisational gaps, leading to sub optimal care outcomes.
- Incomplete care pathways that lead to inefficient delivery of care.
- Lack of opportunity to take a holistic view of the patient, leading to avoidable ill health.
This has been compounded in recent decades by an ageing population, whose health and care needs have become increasingly complex and who require a fundamental shift in the way care is delivered. A view backed up in the Health Policy Insights Paper, where it is stated “One in three patients admitted to hospital as an emergency has five or more health conditions, up from one in ten a decade ago”, this is matched by rising rates in conditions such as Obesity & Mental Health, all of which shows a system that requires more effective coordination and collaboration.
The removal of health & care silos will allow organisations to work collaboratively, transforming our healthcare system.
The NHS Long Term Plan, sets out many examples of this focus for better integration e.g. increasing the capacity & responsiveness of community & intermediate care services over the next five years to help prevent unnecessary admissions to hospitals & care homes.
At the centre of the government and the NHS’s drive for integration, sits several key tenets, the following of which Block see as critical to the delivery of integrated care:
- NHS and Local Authorities ‘Duty to collaborate’: This will support the right individuals and teams working together to deliver more effective joined up care.
- Reducing Bureaucracy: To remove the barriers that exist, and which currently prevent more efficient collaborative working.
- Leveraging of technology and digital services: This will provide the tools and capabilities to allow integration to occur more seamlessly and at pace.
NHS Implication
The legislative change planned to take effect in April 2022 aims to support breaking down silos and create a more effective and less bureaucratic environment for joined up working to flourish. This however will be the culmination of many years of work, NHS England set out in their description of the journey to Integrated Care, that six years ago we began to see through the lead taken by ‘vanguard’ sites, the development and testing of new models of care, driving new effective ways of working. This led, a year later, to the development of Sustainability & Transformation Partnerships, where we began to see greater collaboration between Health & Social care, ultimately leading to the creation of Integrated Care Systems.
The focus on the connection to social care will be key in Block’s opinion to the overall success of integrated care. Social care in isolation has seen significant growth in activity in recent years with 1.9 million adult referrals in 2019/20, a 6% increase since 2015/16. [1] Without effective integration in both adult and indeed child social care, the entire system will not be able to operate effectively.
The same is true in our opinion for the need for greater focus on Mental Health service integration. Pressure on the wider health and care system, brought about by increasing mental health requirements will not be solved in isolation and needs to be part of the wider solution. This need is shown well by the fact it is predicted that the proportion of people aged 65+ with four or more diseases is set to almost double by 2035, with around a third of these people having a mental health problem. [2]
The NHS Paper, Integrating care: Next steps sets out many key components that will provide opportunity to organisations delivering integrated care in England by April 2021. It is Block’s belief that key to success is organisations in all settings being able to collaborate more formally to provide patient centred care. Further to that we see the focus on strategic commissioning, centred on population health outcomes being critical to success. This however is only part of the story, cultural & political alignment in all senses will also play a major role in enabling joined up care to function in the years to come.
Digital Opportunity
A critical component of delivering integrated care is leveraging new digital ways of working. Block see digital as a catalyst to the breakdown of organisational boundaries, creating standardisation and enabling staff and patients to interact in more collaborative ways. The NHS’s Integrating care: Next steps paper provides focus on the digital transformation journey that is required, but Block believes it is the role technology will play in delivering that system wide digitisation, which will ultimately support the long term digital aspirations of the NHS. For that reason, Block believes the delivery of an infrastructure transformation plan for each ICS is a fundamental step, facilitating organisations to come together under a shared vision and plan.
As one of only three HIMSS accredited INFRAM assessors in the UK, Block can work with individual organisations and across integrated care systems to assess the infrastructure maturity of a diverse set of organisations, bringing a standard framework to allow organisations to work towards the delivery of a shared infrastructure and developing a roadmap that allows organisations to develop outcomes that serve a common purpose across all members of the ICS.
In addition to our broader approach to infrastructure maturity, Block has many solutions critical to the delivery of integrated care. From an enterprise network perspective our software defined local area network and software defined wide area network solutions provide levels of security, management and control that enable organisations to come together under one integrated umbrella, delivering flexibility and control to meet the most critical and complex challenges that healthcare organisations are likely to face.
Block’s integration focus within the collaboration domain provides a seamless and consistent experience for users. The approach we have taken has been informed by our belief that collaboration solutions need to give healthcare organisations flexibility and accessibility, allowing them to come together in terms of people and process, without the technology proving a barrier to integration. Our approach enables staff and patients to leverage a range of collaboration technologies in a consistent and effective way. We have developed solutions that seamlessly link the Acute, Community & Primary care settings, delivering solutions for telephony, messaging, and contact centre that are consistent and accessible, and which support the Integrated care journey.
Finally, from a workspace perspective, our Future Ready desktop delivers a user experience that irrespective of geography or organisation, provides a performant environment, that is accessible and secure in equal measure.
The possible complexity that comes with integrated care and the need for users to work in an agile and flexible way has been compounded over recent years, particularly during the Covid pandemic. It has led to significant shifts in working practices, where staff are no longer restrained by working from one location and require the tools to allow them to work not just remotely, but with complete flexibility and agility. The delivery of integrated care will act as a catalyst to that requirement and Block’s Azure desktop is able to drive a consistent and flexible experience for users that are now part of an integrated world.
