Integrating for better outcomes – the time to act is now

John Ryan, Associate Director at Attain talks about the burning platform of Integration and the drive towards a more sustainable and outcomes focused system for health and social care commissioning and provision

Delivering the best possible care and support for people when they need it most sits at the heart of all health and social care systems. But all too often this aspiration is thwarted by a lack of coordination, an overly complex system for people to navigate around and a duplication of efforts leading to inefficiency and wasted resources. Separate systems, organisational sovereignty and a fear of the unknown all too often lead to transformational torpor and it is in this self-induced environment that the people we aspire to support suffer the most. There are however a few simple steps that organisations and systems can take to help move on from this situation and develop into truly patient centred, outcomes focused and effective commissioners and providers of health and social care.

  • Having a clear vision, that is developed, owned and lived by the system and all of its constituent parts – citizens, commissioners, providers – is crucial to ensure aspirations can be turned into reality. This vision should focus on the success triangle of:
    • Improving quality and experience of health and care services
    • Improving population health outcomes
    • Reducing per capita costs of health and care provision
  • Understanding relationships and partnerships and having a clear strategy in place to nurture and manage them. System leaders have a critical role to play in this area helping organisations maintain their individual accountability whilst at the same time fostering a culture of collaboration and collective success.
  • Ensuring quality and performance are the heartbeat of the organisation with a constant focus on maximising the impact of services for the individual whilst maintaining value for money and efficiencies.
  • Looking to new contract models and new care models to move from traditional transactional and episodic service provision to a more outcomes focussed approach which embraces the principles of capitated or whole population budgets to share risk and truly reward innovation and success.

The drivers towards a more integrated approach to commissioning and providing services have never been more defined or more relevant. Integration now has more of a legal grounding than ever before with clear policies describing integration as the future for health and social care provision. The Cities and Local Government Devolution Bill paves the way for at scale joining up of local and regional budgets with opportunities for significant service integration at a level never seen before in the UK. Recently published guidance on Sustainability and Transformation Plans (Delivering The Forward View: NHS Planning Guidance 2016/17–2020/21) also recognises the need for more place based delivery of services with a shift away from organisational separation and autonomoy. Our health and social care systems are at a critical point where traditional approaches to commissioning and providing services are no longer fit for purpose and our citizens are demanding a more centralised role in the development of future service models.

Moving to a fully integrated system is a significant undertaking which can, at first glance, seem to be too much for many organisations to consider. However, keeping the above principles in mind and maintaining a ruthless focus on the reason we all work in the care environment – improving the wellbeing outcomes for our citizens – will help start and maintain the transformational journey towards a better, safer, more responsive and sustainable system for all.

Attain supports individual organisations and systems to improve people’s wellbeing and care, through the development, design and implementation of sustainable, outcome focused and integrated models of care. We are working with clients across the country to deliver their integration plans and are key enablers in several Vanguard and Pioneer projects.

If you would like to learn more about how Attain can assist you in the planning, design and delivery of integrated services, please contact Gareth Hartley, Director Service Transformation or Helen Pyecroft, Head of Strategy.