“The closer integration of health and social care has been a goal for many years, receiving broad support across the political spectrum,” observes Deborah Rozansky, health and social care consultant and associate at the Social Care Institute for Excellence (SCIE). “The ambition is laudable,” she says “but making integration real has been a struggle at times.” Deborah uses this guest blog to explain how a new evidence-based model could lead to better coordination of health and care services.
Whilst working towards the common goal of closer integration, individuals and organisations are constantly striving to reconcile national policies with local ambitions, whilst operating within tight funding and budgetary restrictions.
Lately, efforts to deliver integration have been overshadowed by concerns about patient flow in and out of hospital, emergency admissions and delayed transfers of care. Somehow, the original purpose of integration has been lost in the shuffle.
Getting back to the basics
Part of the problem has been a lack of consensus about what good integrated care looks like and how we might achieve it. To get back to these basics, SCIE has produced a tool that we believe will re-energise the debate and speed progress towards integration’s original goals.
Drafted in the form of a logic model, our tool allows you to take a step back and look at the whole system of care, providing an evidence-based roadmap that demonstrates how health and social care services can be better coordinated around people’s needs. Through this model, integration becomes not the destination itself but a continuous process towards better care.
We originally developed the logic model as part of a research programme commissioned by the Department of Health. The logic model incorporates the interventions that have been shown to work in practice, starting with older people who have complex needs; the structural changes required to enable system and service changes; and the outcomes integrated care is expected to deliver.
Accelerating local integration
During the model’s development, enthusiastic feedback from service users and stakeholders suggested the model had potential as a tool for accelerating local integration efforts. We now need your help to refine the tool further by exploring how people use it in practice:
- Does use of the tool help people understand what they are doing well, what might be getting in the way of progress and where there are gaps you need to address? Does it assist you in prioritising improvements in your service model?
- In what ways does the tool help you engage with service users, health and care professionals and providers?
- Are you able to use the tool for different population groups, not just older people with complex needs? How might it be adapted to include other types of services, such as housing, community and mental health?
Email your thoughts to us at firstname.lastname@example.org and make the subject line 'Integration scorecard'.
One of our next steps will be to create an interactive digital version of the tool that links to further resources and support, such as the research evidence, good practice case studies, checklists and other development tools. We also plan to test, evaluate and refine the metrics that underpin the logic model.
The tool brings us back to the original purpose of integration and sets out a roadmap for taking us there. If we are to progress towards achieving this promise and realising the benefits of integration, getting back to basics is vital. We hope as many people as possible will work with us on this journey.