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The King’s Fund recently hosted a roundtable event which brought together health and care system leaders from across England. The discussion focused on the role of Integrated Personalised Commissioning and how it help deliver a truly integrated NHS service with real choice for people who need it most. Sam Bennett reflects on the day and outlines what the next steps should be.
Earlier this month, The King’s Fund hosted the first in a series of roundtable events for senior leaders from Integrated Personalised Commissioning (IPC) sites across England that will culminate in a conference open to all this coming winter. We had a great turnout from Directors of Commissioning in the NHS to Directors of Adult Social Services and Directors of Public Health to voluntary sector CEOs. The events are designed to create a facilitated space for local leadership from across IPC systems to share their learning and to look at the role of IPC in the context of wider health and care developments.
IPC is an NHS England and Local Government Association programme that is reshaping the way health and care will work for people with high, ongoing support needs in future through personalisation and community based support. Central to this is the scaling up of personal health budgets (PHBs) and integrated personal budgets, which enable people to combine resources from the NHS and councils around their individual needs and preferences.
So at this first gathering, we were invited to step back and consider progress and next steps of Sustainability and Transformation Plans and the delivery of the Five Year Forward View by The King’s Fund CEO Chris Ham and James Sanderson, Director of Personalisation and Choice at NHS England.
Richard Humphries from The King’s Fund, who facilitated the day, observed that the achievements of over forty years of initiatives to integrate health and social care had been limited. They had almost been all top-down and concerned with organisations, budgets, processes. The potential for individuals to integrate their own care and support had barely been explored. This is a radically different proposition which disrupts traditional ways of working at a time when both the NHS and local authorities were facing the toughest financial climate in their history.
Nevertheless the commitment on the day of the IPC sites managers was palpable. National and international evidence indicates that the best examples of integrated care have been developed from the bottom-up in response to locally agreed needs and aspirations – exactly what the IPC sites are trying to do.
The IPC programme is at a pivotal stage, with 6 Early Adopters joining the existing 12 Demonstrator areas in January to begin the process of national rollout that will be driven through the wider implementation of New Care Models.
We have been clear that IPC is now about getting clear on the how rather than determining if the approach will be mainstreamed, and sites are making excellent progress but there is heavy lifting ahead to fully embed the programme into business as usual. Against the backdrop of a crowded and complex change agenda, local leadership will be a vital ingredient in enabling the programme to realise its full potential to improve people’s health and wellbeing and deliver greater value for the public purse.
Despite the many challenges ahead, the prevailing mood amongst the leaders was one of cautious optimism. Whilst each area is at a different stage of development with their IPC programme, there were some common themes.
IPC sites now have growing confidence in the model and enthusiasm from the staff teams implementing it;
The value that leaders have found in radically rethinking health and social care integration through the lens of personalisation, where in the context of increasing pressures and questionable results from system level integration, IPC is offering a compelling narrative and a clear mechanism for joining up health and care around each individual;
The flexibility sites have enjoyed innovating and giving permission to frontline staff to work differently within a clear framework and with support from the national programme.
We are confident that the programme is heading in the right direction and making a difference. We have seen a 174% increase in the numbers of people accessing a PHB or integrated personal budget in the last 15 months and are seeing increasing appetite for IPC as a model for personalising care beyond initial target groups.