NHS Confederation - Neighbourhood integration: how local health and care needs are being met

21 Jul 2020 11:07 AM

The COVID-19 pandemic has accelerated the integration of care in the community across England, with organisations often working together at a neighbourhood level to meet the needs of their local populations.

Before the pandemic, the Community Network, run jointly by NHS Providers and NHS Confederation, initiated a project to capture where local service integration was already well underway. The result is a series of case studies focused on how more joined up care has been delivered, and three briefings looking at the ways partners have resolved common operational challenges that so often hold back the integration agenda – around governance and shared working practices.

The key lessons from the six publications include:

For successful transformation to take place, strong relationships, a sense of common purpose and transparency must be shared between the project partners.

• To build momentum, leaders need to remind staff at all levels of the vision and rationale for bringing services together.
• Leaders need to drive cultural change by modelling the collaborative behaviours they wish to see. 
• Partnering with organisations outside of the health and care sector is vital to ensure that the wider determinants of health and wellbeing are integral to the support people are offered.
• Being located in the same building can be hugely valuable in fostering collaborative working.
• IT and information governance arrangements should be prioritised early on.

These best practice examples highlight the practical strategies health and care organisations have used to deliver more joined up care. This is more important than ever in the time of COVID-19 with the NHS facing unprecedented pressures to recover and to redesign how services are delivered to meet patient needs. There is a need to capitalise on any progress made during the crisis which can be sustained and to avoid sliding back into old siloed ways of working.

The project includes four place-based case studies:

• A system wide collaboration in Luton to deliver enhanced care for frail patients with a record of emergency hospital admissions;
• The escalation avoidance team in Norfolk, providing a single point of access for managing unplanned health and care needs;
• Work in Leeds to bring together health and care providers, housing, employment services and the third sector through local care partnerships;
• Multidisciplinary integrated care conferences in Haringey and Islington to co-ordinate support for people with complex needs. 

It also includes briefings on common barriers to integration:

• How partnerships in Hull, Worcestershire and Newcastle have set up effective governance arrangements;
• How organisations have developed shared working practices, including the One Northern Devon initiative.

This project is a collaboration between NHS Providers, the NHS Confederation, the National Association of Primary Care, the Association of Directors of Adult Social Services and Association of Ambulance Chief Executives. It has been funded by NHS England and NHS Improvement.

Andrew Ridley, chair of the Community Network and chief executive of Central London Community Healthcare NHS Trust, said:

“This series of publications by the Community Network highlights the successes of local organisations working collaboratively to help promote better health outcomes for patients and to meet the needs of local populations. It shares ideas and approaches that may help others in strengthening local services.

“While the interviews took place before COVID-19, it is now more important than ever to ensure that the health system meets the needs of its local people – to help keep them safe, particularly while the NHS recovers from the challenge of the first peak of the virus, and considers how services in the future will be delivered.”