Why is integrated healthcare important to providers?

Dr Rachel Lucas Interim Director of Psychological Services South Staffordshire and Shropshire Healthcare NHS Foundation Trust

Our Trust’s core values• People who use our services are at the centre of everything we do

They are our reason for being

• We value our staffWe cannot deliver effective services without well supported and trained staff

• Our partnerships are important to usServices which work together on common goals delivery better results

Why integrate?

Where care is not integrated, it is those who use services who can miss out, become lost and are failed

‘People diagnosed as having schizophrenia have poor access to general practitioners and general hospital care; their physical health suffers and their life is shortened by 15 to 20 years.’

Executive Summary, The Abandoned Illness: A Report by the Schizophrenia Commission. 2012. Rethink Mental Illness

‘The fragmentation of services means that people who have a recurrence of their psychosis lose the established relationships with professionals they trust, and instead feel shuttled from one team to another as if on a factory production line.’

-Integrated Health Services - What and why?, Technical Brief 1, 2008, World Health Organisation

Integrated service delivery is “the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money.”

Integration is a means to an end, not an end in itself

- So that those who use services receive health care that is seamless, smooth and easy to navigate and addresses health as a whole - WHO, 2008

So why not more integrated? Fragmentation and partition of services has been sought in an attempt to drive quality and contain costs

Spiralling health care costs within the huge organisation of NHS has lead to various measures to try to focus and rationalise expenditure

Current and projected demands on healthcaremean that it is not possible to return to and/orexceed previous levels of integrated provision,without both ensuring the integration isenhancing the quality for those using servicesand maintaining efficiency

Canterbury, New Zealand, 2007

Integrated healthcare, ‘One system, one budget’

So how can we ‘safely’ integrate? In reducing fragmentation and enhancing

integrated provision we need to incorporate integral vehicles to maintain quality and

efficiency

Recovery principles• Encouraging responsibility for own health self-

care• Providing assistance in or as close as possible to

home• Providing the minimum interventions necessary

to enable someone to move forward in their life

• Observation essential• All voices are equal – stop the line• If it benefits service user, doesn’t cost more

and isn’t illegal – go for it!• Sponsors – senior within organisation• Follow-up 30,60,90, 120 days

LEAN quality Improvement

Need to increase partnership working• With family/carers• With other providers Focus on, ‘needs to an end’,... Because those who use services are central