PPL Blog: Delivering Better care – 3 lessons about how to deliver integration

PPL Blog: Delivering Better care – 3 lessons about how to deliver integration
posted 06 May 2015

By Catherine Parks, Senior Consultant, PPL

Catherine Parks wrote an opinion piece based on the long-lasting lessons and approach we should be taking to furthering the integration agenda. 

Delivering Better care – 3 lessons about how to deliver integration

The future of our health and social care services is a hot topic at the moment. It’s a key focus for the election and - regardless of what happens on 7 May, it is clear that increased integration will be a key aspect of service delivery going forward. We all know that integration is the right thing to do: it will improve outcomes for patients, people who use services, their carers and families. It will help ensure that care is centred around the needs of a person, not based around services, and will help to give people choice about how and where they receive their care. It will enable greater independence and support people to live in their own homes for longer. But, making it happen is hard: transforming how we work to deliver better outcomes is challenging, regardless of how much everyone shares the ambition to achieve the outcome.

Now local BCF plans have been approved the focus has moved from articulating an ambition about service redesign to making real change happen on the ground. With the official launch of the Better Care Fund Exchange this month we have been busy working with central and local change leaders to support their efforts to deliver better care.  Our work supporting the BCF programme has caused me to reflect on what we are learning about integration. It draws on input from over thirty national and local leaders that we worked closely with over the past 3 months, a literature review of good practice, and – more recently – the better care parliamentary event hosted by the better care support team on 24th March, the Guardian online discussion about the future of integrated care and the Making Better Care a Reality Cascade events held in early April.

To me, this work has highlighted three insights about how to deliver integration.

Co-production is key to success

Top down change initiatives don’t work. Engagement isn’t a box that needs to be ticked off as part of a project checklist but a key facet of transformation that will help ensure sustainable change.

The reason co-production can get relegated to the bottom of the to do list is that it’s hard and time consuming. And the reason that it’s so important is that it helps involve people in the change process, encourages innovation and develops new ways of looking at challenges. Co-production should involve working with patients and people who use services, their carers and families, provider organisations and your own staff to build a shared narrative about what success will look like. The effort you put in at the start will pay dividends by the end of the project, ensuring an aligned vision and engaged staff, providers and citizens who will help ensure sustainable change.

Build relationships with other localities and share your insights and barriers with them

A key benefit of a national programme focusing on better care is that all areas in England are working to the same mandate and going through similar experiences. This provides a real opportunity to build new networks and share learning and experiences between areas, as was demonstrated by the networking at the parliamentary launch event. To facilitate network development at a national scale the Better Care Exchange is being developed. The Exchange, which will be launching later this month, will act as single, accessible, place for sharing learning, information and good practice on delivering better, integrated health and social care.

Be brave: don’t wait for permission to trial new initiatives

There is no blueprint for better care: integration between health and social care on this scale has not been done before. This can be intimidating and may make some sites cautious about proceeding without clear guidance and recommendations from national bodies. But one of the most exciting aspects of better care is that it can be tailored to the needs of the local population. There isn’t a prescribed approach, which gives sites freedom to tackle specific issues and challenges in their area. This freedom gives areas the chance to design services from the bottom up, which combined with knowledge sharing tools creates the opportunity for trialling new initiatives and determining what works best locally.

The future of our health and social care services is a hot topic at the moment. It’s a key focus for the election, with the main parties in broad agreement that increased integration will be a key aspect of service delivery going forward. We all know that integration is the right thing to do: it will improve outcomes for patients, people who use services, their carers and families. It will help ensure that care is centred around the needs of a person, not based around services, and will help to give people choice about how and where they receive their care. It will enable greater independence and support people to live in their own homes for longer. But, making it happen will require significant change and working differently is always challenging, regardless of how much everyone shares the ambition to achieve the outcome.