Newsflash: Making Sense of Integrated Care

“Our aim is to use the next several years to make the biggest national move to integrated care of any major western country” (NHS England, 2017)

Quite a claim, but this is no pipedream and changes are being made across England to make this a reality. The Sustainability and Transformation Plans published for each region set out a roadmap for achieving this objective and many propose Integrated Care Systems.

If you are confused by the ever changing models for integration (Accountable Care Organisations, Integrated Care Systems, Integrated Care Partnerships, etc) The Kings Fund has just published a very useful guide to these systems, the work underway across England to implement them and NHS England’s proposals for an ACO Contract.

The guide also highlights some of the difficulties arising from the fact that these systems have no statutory basis and therefore rely on the willingness of the participants to work together to plan how to improve health and care in their area.

NHS England also recognise that the transition to these systems is complex, will require staged implementation and that the move to a contract with a single health and care organisation will take several years. As a result, NHS England has decided to delay the use of the proposed ACO Contract for now.

The concern about privatisation of the NHS is also considered, but the conclusion is that, “rather than opening up the NHS to increased privatisation and competition, these developments are likely to have the opposite effect”.

The guide also recognises the difficulties in using competitive procurement to promote integrated care, and one of the key conclusions is that changes in legislation will be required to implement NHS England’s objective. There is no prospect of this happening in the short term and, for the foreseeable future, the participating organisations “will have to find ways of making progress through workarounds”.

The guide can be found here and, if you would like to discuss any of the workarounds that we have developed in our work with primary care practices and organisations, please contact Ross Clark.

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