Integrated care and support

National collaboration for Integrated Care and Support

NHS England is one of the key partners on the National Collaboration for Integrated Care and Support. In May 2013, NHS England as one of the key national partners, signed up to a series of commitments on how we will support local areas in delivering integrated care and support in the first ever system-wide ‘shared commitment’, ‘Integrated Care and Support: Our Shared Commitment’.

For health, care and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carer and family. It means moving away from episodic care to a more holistic approach to health, care and support needs, that puts the needs and experience of people at the centre of how services are organised and delivered.

Where local areas have succeeded in integrating health, care and support services, too often it has been despite of the national system rather than because of it. This is why NHS England has joined a range of national partner organisations to tackle national barriers and enable and encourage locally-led, integrated services to flourish.

Integrated Care and Support: Our Shared Commitment

In May 2013, the national partners have co-produced ‘Integrated Care and Support: Our Shared Commitment’, a framework document on integration. The document, signed by all the partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.

A Narrative for Person-Centred Coordinated Care

National Voices, a national coalition of health and care charities, has developed a person-centred ‘narrative’ on integration (also available as an easy read version). This is an agreed definition of what we mean by ‘integrated’ care. It provides a guide to the sort of things that integrated care will achieve, such as better planning, more personal involvement of the person using services, and free access to good information. It also provides some clarity over what local areas should be aiming to achieve practically, in their efforts to integrate services.

It is written not just for the experts, but for patients, people, families and carers. It shows them what they have a right to expect, so they can then demand the most helpful care and support.

As a national partner we have adopted this definition of what good integrated care and support looks and feels like for people, and we are asking local areas to sign up to using it too.

Pioneers Programme

Members of the Integrated Care Pioneers Programme are demonstrating the use of ambitious and innovative approaches to efficiently deliver integrated care. They are already working across their local health, public health and social care systems, showing how integrated care and transformational change can happen in practice.

On 1 November 2013, fourteen ‘first wave’ pioneer sites were announced. The Integrated Care Pioneers: One Year On Report 2014 sets out the Pioneers’ successes and challenges during the first year of the Programme.  View more examples of pioneer profiles and case study.

A further wave of eleven Integrated Care Pioneers were announced on 27 January 2015, widening the learning community to 25 sites spread across England, working on unique local challenges, yet sharing some similar approaches and challenges.

Pioneers support the rapid dissemination, promotion and uptake of lessons across the country and receive central support to breaking down these barriers provided by the national partners. The national partners also support the sharing of learning to support all areas in overcoming barriers to integrated care and support at scale and pace, so that it becomes the norm rather than the exception.

The support programme available to Pioneers is tailored to meet individual pioneer’s needs, building on existing activity and offers, and enabling a greater focus on practical support for live implementation.  This, in turn, will generate invaluable early evidence for approaches and models that could be disseminated and implemented across the country, ensuring that being a pioneer remains at the forefront of cutting edge developments in relation to integration.

Better Care Fund (previously the Integration Transformation Fund)

The £3.8bn Better Care Fund (BCF) was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and social care. The BCF is a single pooled budget to support health and social care services to work more closely together in local areas.

The BCF not only brings together NHS and Local Government resources that are already committed to existing core activity, but also provides a real opportunity to improve services and value for money.  Whilst the fund itself does not address the financial pressures faced by local authorities and CCGs, it can act as a catalyst for developing a new shared approach to delivering services and setting priorities.

NHS England, alongside the Local Government Association (LGA), published a series of joint letters to the NHS and local government, with details of the Better Care Fund scheme and its requirements.

The BCF is a critical part of, and aligned to, the two year operational plans and the five year strategic plans. The BCF planning page contains the guidance and template plan, as well as available support/resources.