Integration of care: large-scale and at a good pace

by Derrick Corea Technosoft Innovations, Inc

Currently, in the United Kingdom, health and social care services are fragmented, and therefore unable to respond to the needs of the population.

Aware of this, the government is committed to promoting the integration of care in the different areas of action of the National Health Service (NHS).

For this, the "King's Fund", an entity committed to the integration of care, has developed a guide that guides the process of turning this intention into a reality, presenting a summary of "key steps" that will result in changes in the terrain, in a real, local way, and at the necessary and desired scale.

The authors summarize in 16 steps the process of converting the integration of care into a reality, and are based not only on work previously prepared by themselves, but also on opinions and witnesses of experts and actors involved in the topic, to share the good practices.

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Will the road to the integration of care progressively be made or do we have to change gear? A first premise pointed out by the authors is that the incremental adjustments to current services and practices will not be the way to face the existing pressures, financial and quality of services. In fact, a real change of pace and a strong commitment to the future of austerity expected for public services is needed.

 

Likewise, this commitment will have to be transversal to the entire system, and it can not be limited to health and social care services only. We must also involve all the services that influence the health and well-being of societies.

 

In this sense, the first actions are structured around the creation of a consensus, of all those involved, with respect to the common cause, to the shared vision and to the objectives, together with the teams of professionals and users.

 

The work dynamics, the shared leadership and the management of the temporal and procedural change are key for a clear understanding and progression. On the other hand, a prioritization and selection of the areas with the greatest potential for improvement should be made, which should, in turn, also affect the architecture of the system. In this aspect, for example, the importance of the creation of multidisciplinary teams is highlighted, with professionals and clinicians in agreement with the area or service that is being integrated, which is not identical to the merger between organizations.

 

Is there an infallible "formula" for the integration of care, or is the process based on the discovery and lessons of experience? It must be clear that there is no single way to integrate care, and in addition to identifying and making a "pool" of available services and resources, we must be open to innovation in the contracting of services, as well as to the model of prices or incentives to establish.

 

Greater participation and awareness among users is also of great importance for the proper functioning of integrated systems, as well as the circulation of patient information, so as not to slow down the integration of services.

 

Finally, we must be prepared and be realistic with regard to necessary investment, before we can move towards the integration of services and take into account that, although there is room for improvement in cost optimization, related to duplication of services or waste, there is no evidence that integration allows services to be delivered globally at a lower cost.

 

The experience of the organizations that have already made the transition indicates that the road is long and arduous, and the approach of this type of intervention towards integration (considering a minimum of 5 years, and in many cases even more) requires that all these initiatives are articulated in a joint strategy.

 

Once there are no universal or unique solutions, the authors stress the importance of discovering rather than designing, and sharing experiences and good practices when developing initiatives.

 

There are already many initiatives in practice on these same issues, simultaneously, in different locations and areas of the NHS, so this last recommendation is essential. But it is also essential that there are key changes in the policy, at the governmental level. This may include changes or adjustments in payment systems, for example, so that changes and local actions are possible from the point of view of the incentive.

 

Likewise, part of the integration of services in the field also goes through the policies, regulations and financial and economic framework applied by the government, to support and specify the process.

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Created on Apr 18th 2018 04:36. Viewed 256 times.

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