Policy-makers, academics, professionals, users, innovators and industry reps came together last week to discuss the latest learning on collaborative working at the King’s Fund’s annual Integrated Care Summit.
Rob Kenyon, Chief Officer for Health Partnerships at Leeds City Council, who presented at one of the sessions, shares his learning points from the day.
Many people have said that integration is an idea whose time has come. It’s what patients and citizens want, it makes sense to practitioners and it has the potential to save money. By and large, everyone agrees that it’s integral to the future organisation and delivery of health and care.
But it was clear from the breadth of experience and variety of perspectives on display at the Integrated Care Summit that when we talk about ‘integration’, we are encompassing a number of different approaches. Integration is not ‘one size fits all’, it means different things for different areas, and there’s not necessarily a right and a wrong way to ‘do’ it.
Here are the main things I took from the day:
- There are loads of models of integrated care out there – probably as many as there are health care systems.
- Integrated care is likely to be no less expensive. It probably won’t save us from that ‘burning platform’. But that doesn’t mean it’s not the right thing to do.
- We need to invest in other mechanisms to save money. The system is generally very good at finding efficiencies, but we need to be more innovative and adventurous. Those of us involved in developing local Better Care Fund plans can testify with our own sweat and blood to this.
- If you’re waiting for the evidence base to tell you what model of care to adopt locally then you may have retired by then. It will be 5-10 years at least before we have a clear and coherent understanding of impacts and efficiencies.
- Different places need different models. Even if the evidence does provide the ideal answer in Leeds can we really expect that the exact same model will work in Newcastle, or Manchester, or Birmingham? Successful projects will borrow elements of good practice and use them to enhance our own models. We must start with our own population and priorities and tailor initiatives to local need.
- Evaluate early, often and with rigour.
- Homeopathic levels of integration do not work. More coordinated, collaborative care designed around patients is crucial and should be done at scale.
- Be prepared to adopt plan B if plan A isn’t working. That sounds obvious, but it requires admitting that something didn’t work in the first place and we have typically not been very good at doing this.
So in summary: We need to do something. Do it now. Do it at scale. Measure it, and measure it again. Make different plans to save the money that needs saving today and stop conflating the two. If it works, then carry on. If it doesn’t, then stop and stop quickly. Then try Plan B, learn and repeat.
As I got on my bike after the summit I reflected on the discussions. We heard much about models of care, pathways and processes that we should all learn from and could adopt. But much as we might like it to, what works well in one place won’t always work the same in another.
My 2-year-old daughter is very happy with her balance bike. She likes how it is the ‘same’ as mine, with handlebars, two wheels and a seat, but with some differences that make it practical for her. The thick, small wheels work really well; no punctures and very stable. Perfect for her needs. Useless for my commute, though.
Chief Officer for Health Partnerships