Integrated Health and Social Care

Integrating Health and Social CareThere is a fault line in the way in which health and wellbeing services for people are resourced, planned and delivered in the UK. Essentially it is the organisational and financial separation between the NHS and Local Government created in 1948. It inadvertently produces discontinuity of care for service users, massive frustration for professionals and inefficient use of resources.

Because of the fault line, the investor in health and social care is not always the financial beneficiary in savings. Our evidence-based practice catalogue shows the proven interventions where partners can invest for own benefit, mutual benefit or the benefit of the other partner. It enables them to align and coordinate what really works for older people.

Each bubble in the matrix below shows the interventions formulated for a client system and where the main benefits and investment would fall. For example if the NHS invests in continence management it would benefit the NHS through reduced A&E attendances and hospital admissions, but even greater benefit would accrue to Local Authorities through avoidance of care home admissions and reduced need for domiciliary care packages.

Integrating Health and Social Care

Evidence-Based Interventions

Our pathway is backed by an evidence-based catalogue of services and interventions proven to work well at each stage of the pathway. But we don’t just come with ready-made solutions to impose from elsewhere; we look for what works well locally and blend in the best practice.

By proven we mean either gold standard [Randomised Control Trials or independent evaluation] or substantive evidence supported by reviewer experience.

The reality is that service commissioners and providers can’t always wait for the delivery of academic studies, randomised control trials or independent evaluation evidence to back up what they think is the right thing to do. We know that academic studies on interventions seldom look at the receptiveness of the wider system when evaluating interventions. We also know that interventions that are considered to have little benefit from academic meta-analyses can often have very significant benefits in case studies from local systems. So we back up the RCT and evaluation evidence by what we know from personal and practitioner evidence and case studies.

Our whole systems approach allows the partner agencies to identify the services they provide and the resources they commit to each of the pathway stages and settings. We help spot the gaps and then build up a coordinated set of services designed around the individual older person.