Integration resources
Whether you are a Forward View Vanguard site or developing your own redesigned model of care, either as commissioner or provider, our Integration Portal is designed to help you to answer these questions and provide many other useful resources.
It sets out the issues that you will need to consider to make it happen:
- Governing for transformation: STPs and governance
- Articulating the rationale for integration
- Choosing your new care model
- Choosing the right organisational form and legal model
- Making changes to the way services are delivered
- Getting the governance right
- Sharing information and integrating technology
- Commissioning a new care model
- Complying with procurement law
- Contracting options
- Complying with competition law
- Workforce implications
- Making the most of estates opportunities
- Regulatory considerations
- Accountable Care Organisations
- Implementing Carter – Sharing the lessons of shared services and outsourcing
An introduction to integration
The NHS is developing new care models to redesign health and care systems to improve quality of care, reduce health inequalities and address productivity and efficiency challenges.
At the Vanguard sites chosen to develop the models of care proposed by the NHS Five Year Forward View commissioners and providers of health and social care services are working together to redesign their local systems. In other areas new models of care are also emerging in Sustainability and Transformation Plans required by the NHS Shared Planning Guidance 2016/17 – 2020/21 and through devolution bids.
All of these developments aim to support improvement and integration of services by breaking down traditional divides between primary care, community services, secondary care and social care and by delivering increasingly personalised and integrated care for patients. The assumption is that if organisations work together then better outcomes may be achieved.
New care models will involve all types of commissioners and providers of NHS-funded and local-government funded services.
Organisations will need to consider what they are trying to achieve and then choose a care model to deliver their objectives. As a leader or participant in a model the key questions you will want to be able to answer are:
- What is the rationale for a new care model in terms of improving quality of care, providing more integrated services, increasing productivity and releasing efficiencies?
- What model of care will best support us to deliver our objectives?
- What legal flexibilities do we have to set up our chosen model of care?
- What are the barriers and risks and how do we address governance issues?
- Do we need a new type of organisational form for delivery and, if so, do the organisational forms suggested by Examining new options and opportunities for providers of NHS care, The Dalton Review provide the answers?
- How can we move quickly to get on with our plans?
Testimonials
Engaging early has allowed us to consider our strategy in line with the relevant procurement law position, taking advantage of additional flexibilities that were available. We have been able to build relationships right from the beginning of the project to support our new care model proposal.
NHS Stockport CCG, participant in Stockport Together Multispecialty Community Provider vanguard
First and foremost, the high level of trust between the partner organisations allowed us to develop a really strong vision for what we wanted to achieve. Our aim was to be ambitious by creating an Integrated Care Organisation that would integrate adult community, mental and acute health and social care services for the benefit of our population. Identifying a preferred organisational form – a prime contractor model – at a relatively early stage, meant that we were able to move forward into the detailed discussions necessary to make the ICO a reality. A rigorous project management process has also been essential to the success of the programme.
Salford Royal NHS Foundation Trust, participant in Salford Together Primary and Acute Care System Vanguard
Our pioneering project aims to integrate primary, secondary and community care in one organisation. We have achieved this by integrating three primary care practices with the trust, with the trust providing NHS primary care services as a sub-contractor to three GMS primary care practices across five sites in Wolverhampton. This project will bring 23,000 patients under the trust’s care and will see the GP Partners continue to provide the primary care services as employees of the trust. The project is all about clinicians across primary, secondary and community care moving to a systems mindset and thinking about the total care of a patient. This pilot is being driven by the GPs and senior clinicians at the trust who are working in the best interest of their patients. But we recognised that to make this happen, we needed to look at organisational form, and that meant integrating the practices with the trust so that we can remove some of the processes that cause delays when multiple organisations are involved and make the system work more efficiently. We will look to share our learning across the NHS locally and nationally.
The Royal Wolverhampton NHS Trust, participant in pioneering vertical integration project