Rolling up our sleeves and getting out of our silos

In this latest blog from the Personalisation and Choice Group, NHS England’s Sam Bennett makes some crucial connections between key national change programmes that are delivering on the Five Year Forward View.

“We have got to get our sleeves rolled up” – said Simon Stevens to a packed house earlier this summer at the NHS Confederation annual conference. “We know what needs doing. Let’s get on with it”, he said in a recent article for the Telegraph.

As Head of Personal Health Budgets and Integrated Personal Commissioning (IPC) at NHS England, it’s my job to help make sure that the NHS is getting on with some of the work that is essential to delivering on the Five Year Forward View vision, namely to enable people with complex needs to have “far greater control of their own care”.

This includes the current expansion of personal health budgets, and the roll-out of Integrated Personal Commissioning, a programme addressing the wider integration of health and social care, centred on individuals, and including the provision of personal health budgets and integrated personal budgets (combining health, social care and education funding).

Like the organisation as a whole, these programmes are now moving rapidly from ideas to implementation and wider spread. Central to making that shift is strengthening the connections across NHS England’s programmes, so that we can be clear on how to deliver the greatest value for the taxpayer and best outcomes for people and communities.

Over recent months the programmes I lead have been working hard to make these connections, progress which was highlighted in James Sanderson’s most recent blog, where he discusses the work we are involved in around end of life care, learning disability and maternity.

More recently, the Mental Health Taskforce Implementation Plan highlighted our work to explore integrated personal budgets for looked-after children and care leavers, which aims to improve mental health and wellbeing outcomes for this group of people.

IPC and New Care Models

Strong connections have also been made with the New Care Models Programme.

Published at the end of July, the multispecialty community provider (MCP) emerging care model and contract framework describes how all MCPs will be supported to “adopt the IPC model fully, and provide personal health budgets to a small but growing proportion of its population”, representing as a key element of the care that MCPs will be accountable for providing.

Much of our learning so far on Integrated Personal Commissioning was consolidated in the IPC Emerging Framework which we published in May. Both publications makes clear the strength of our ambitions, and by 2020 the vision is that IPC will form part of New Care Models, covering 50% of England and playing a critical role in improving the experience and outcomes of care for people that need a particularly personalised approach.

The recent MCP publication describes how IPC will be an important part of providing integrated care and a broader range of services for people with ongoing care needs, in recognition of the likelihood that, “no single provider will ever be able to fully understand and tailor services to…some of its most vulnerable patients”.

In practice, this will mean explicitly building in consideration of IPC and PHBs into each New Care Model, identifying the people locally who could benefit, and linking health and social care personal budget systems and processes to ensure that people experience seamless care. Enabling individuals to opt out of their local provider will also provide a strong incentive to deliver higher quality, personalised care for the wider population.

Green shoots of progress

It’s an exciting time to be involved in IPC, and we’re delighted by the changes that we’re starting to see in how services are delivered and experienced in areas covered by our IPC demonstrator sites.

In his recent blog on the NHS England website, Andrew Carter shares some of the tangible differences IPC is making for people with chronic obstructive pulmonary disease (COPD) in Stockton on Tees.

Similarly, recent examples continue to show the positive impact that personal health budgets can have in terms of improving the quality, flexibility and efficiency of care.

As we continue to work with IPC sites, to roll up our sleeves together and break down the silos, I’m confident these green shoots of progress can spread and grow. We will be expanding the IPC programme in the autumn to continue the great work we’ve seen so far, bringing a number of early adopters on board and further strengthening the connection to New Care Models in the process, so watch this space.

IPC will feature as a pop-up university session at NHS Expo on 8 September.  Book your place on the Expo website.

Sam Bennett

Dr Sam Bennett is Head of the Integrated Personal Commissioning programme and the Personal Health Budgets team at NHS England. He is passionate about personalised care and support and has worked on implementing personalised systems in health and social care at local, regional and national levels for over 10 years.