Integrated care around the world

Integrated care around the world
posted 30 July 2014

On their return from the 14th International Conference on Integrated Care, PPL’s co-founders were interviewed by Adam Hewitt, editor of National Health Executive. The subsequent article appeared in the May/June 2014 print edition of NHE. Thanks go to the editor for his kind permission to reproduce the article here.

Integrated care around the world

Brussels hosted the 14th International Conference on Integrated Care in April. Speakers included Claire Kennedy and Simon Morioka, founders of PPL, which powers the Integrating Care organisation. They updated NHE on the conference and developments back home on integration.

The 14th International Conference on Integrated Care (ICIC) in Belgium in April brought together academics, clinicians, experts and pioneers keen to share the latest global research on the subject.

Among the attendees were Claire Kennedy and Simon Morioka, who have been frequent contributors to NHE via their consultancy PPL’s work with initiatives like Integrating Care and People Powered Health.

They told us it was fascinating to see how the problems with which the UK is grappling – and to which many see integrated, co-ordinated care as an answer – are really so international, and divorced from specific health systems and policies.

Morioka said: “If you look at the content of what people were saying, it would have been very hard to differentiate between people talking from a UK perspective and people talking from the perspective of Spain, or New Zealand, or the Nordic countries. The demographic challenges are the same the world over.”

Kennedy praised the mix at the conference between academic input right through to strategic-level thinking from global bodies like the World Health Organization.

PPL’s own session was on the ‘value’ in healthcare. As Kennedy put it: “We spoke about the concept of value in articulating the case for change, and the benefits it can bring, but also as a way of structuring the nature of that change. It was about the importance of agreeing on a shared definition of value and using that as a lever and a common language that sits across all stakeholder organisations and players to create a shared vision of what success would look like.”

Other UK speakers made the trip to Belgium for the conference too, including representatives from some of the integration ‘Pioneers’ from around England. The North West London integrated care pilot team were well represented, as were speakers from Wales and Scotland.

Morioka said: “A lot of the research being presented was at a very early stage, but it’s clear there are lots of answers out there in the broader world. We’re at the start of a journey. Some people are further ahead, some are behind, but on the general, big challenges people are grappling with – we’re all close to the starting line.”

“A few years ago, people might have been talking about what integrated care is in practice, whether it’s a priority, asking if it is going to make a difference – that’s not being talked about now. The policy argument has been won and people are convinced that this is not just the right thing to do but an absolutely necessary thing to do if health and care services are to be improved and developed internationally. But we’re now struggling with the mechanics of how you do it. That’s where we are now: working through, in a very methodical way, how you make better care work in practice.”

He said linked agendas being developed, and which attracted attention at the conference, included the integration of physical and mental health, and how the integration agenda applies to health and care services for children too.

Kennedy said patient engagement is another important area, one in which the UK is seen as a leader. International participants at the conference were “impressed by both the concept and reality of National Voices”, the umbrella organisation representing patients and patient charities, she said. “The unified patient perspective is respected and built into policy-making and is a given part of the policy process – not a bolt-on at the end.”

National Voices trustee Angela Coulter, an influential voice on patient and public involvement in healthcare, spoke at ICIC about the ‘house of care’: a co-ordinated service delivery model to deliver proactive, holistic and patient-centred care for people with long-term conditions. Coulter published a paper on the ‘house of care’ with The King’s Fund in October 2013.

PPL and Integrating Care held another roundtable event on 30 April (NHE covered the last event, concentrating on the Better Care Fund, in our March/April edition), chaired by Professor Paul Corrigan, focusing on health and wellbeing boards in relation to integrated care. More on that in our next edition.

Morioka called HWBs “our best and strongest bet” on strategic health and care leadership in a locality, and said: “If we didn’t have them, we’d have to invent something like them.”

Another important area of PPL’s work currently is primary care development – expect more coverage of that in future editions. Morioka said: “The sector has tended to see the problem as being around reconfiguring acute services, and getting local populations to buy into those changes. But there isn’t really an example of a good system of integrated care that doesn’t have a strong acute sector as part of it. There is a future for hospitals within better co-ordinated care. To focus on the acute sector is to ignore the massive change that’s going to have to happen in community services, in social care and not least in primary care.”