Home care software provider CarePlanner speaks to the Chair of Bolton NHS Foundation Trust to learn about the purpose of an Integrated Care System (ICS) and the potential of integration in health and social care.
Since 2018, Integrated Care Systems have been introduced around England to try and help bridge the gaps that exist between services in health and social care. In April this year they reached every part of England – something that had been promised in the NHS’s ‘ambitious yet realistic’ long term plan. This initiative followed the lead of Scotland and Wales, which first began integrating their health and social care systems following their respective devolutions. We spoke to the Chair of Bolton NHS Foundation Trust and New Local Professor Donna Hall (pictured) to learn more about the potential of integration in health and social care.
The Purpose of ICSs
So what, in essence, are Integrated Care Systems (ICSs)? “For me, it boils down to thinking about how you work differently with communities and with [service users],” Prof. Hall explains. “Think about earlier identification of issues and wrap services and support around people and communities earlier on.” The idea of ‘wrapping’ services around people and communities is at the crux of Prof Hall’s vision of ICSs. She wants to see health and social care needs be driven by the people who use the services, and the communities that provide them.
“It’s very much about changing the behaviours,” says Prof Hall. “[It’s about] changing the relationships within the system, and trying to push this person centred approach.” This direction reinforces the collective drive in health and social care towards preventative services that can help ease the strain on hospitals and dedicated care facilities. It’s a noble goal, but how do we get there?
Designing the guidance
A key aim when designing the guidance for ICSs was to link up the fractured services with which people interact in order to combine or ‘wrap’ them around the person using them. In other words, ‘joining up’ education, health, social and community services. The basic principle is, the more you understand someone, the easier they are to help.
However, Prof Hall and her colleagues were conscious of the dangers of strict and specific solutions when designing the guidance.
“I was involved in some of the workshops, helping to put the guidance together, and what we said very clearly was, ‘don’t over prescribe’. Don’t make it so heavy on guidance that you squeeze any innovation out of it.”
This lighter touch approach to guidance means ICSs have the room to shape their system to ‘wrap’ around their communities as necessary.
West Yorkshire and Harrogate Integrated Care Partnership
There are several examples of communities who have taken the opportunity to help build a more inclusive and robust system of services. At the vanguard of this initiative, according to Prof Hall, is West Yorkshire and Harrogate Integrated Care Partnership.
The partnership started in 2016 and is responsible for over 2.7 million people and a collective budget around £5.5 billion. It includes seven clinical commissioning groups, eight local councils, 13 care providers and a wide range of third sector organisations. These connections have enabled health and social care organisations to pool resources, knowledge and action to benefit the entire community.
Hard data, soft intelligence
Designing and enacting proactive care requires a combination of data and, as Prof Hall describes it, “the soft intelligence of local community teams.” Initiatives like Primary Care Networks link up public sector services and community groups so they can build more complete pictures of people’s needs and respond accordingly. This addresses the current problem of separate ‘silos of information’ throughout our health and social
Sharing, Caring and Daring
Privacy remains a crucial issue, especially when utilising ICSs. It will be a challenge but a potential reformative one.
“I think there’s more harm done by not sharing, if I’m honest,” says Prof. Hall. “Because we’re not connected enough, joining the dots in the way that I think people expect us, so therefore, people are falling between the net.”
At their core, that is the purpose of ICSs, to join the dots between people, systems and services. It’s a big picture to attempt to draw, and reinforces the fact that this will not be a swift or simple transition to achieve.