No Integration without personalisation:
Each requires the other
Sam Bennett, Director Think Local Act Personal
23rd June 2014
Two parallel policies
Integration
Personalisation
Seeks to address:
- Fragmented service delivery
- Duplicative processes
- Systemic disincentives
- Budgetary pressures on acute care
And to deliver:
- Seamless experience
- Better health outcomes
- More care closer to home
Seeks to address:
- Changing expectations
- Disempowering processes
- Systemic paternalism
- One size fits all provision
And to deliver:
- Choice and control
- Enhanced health and wellbeing
- Community resilience
The only game in town?
“A national collaborative coming together to
confirm a shared commitment to moving
ahead with integration at pace and scale,
including through Integrated Care Pioneers.”
“The Spending Review
announced the creation of
what has become the Better
Care Fund - £3.8B of existing
funds redirected to deliver
better outcomes and greater
efficiencies through more
integrated health and care
services.”
What do we mean when we talk about integration?
•
The narrative for person-centred,
coordinated care aims to ground
integration in what is important to
people.
•
But…too often integration still refers to
something done at the level of systems,
organisations and budgets.
•
There is now an opportunity to bring
together two important agendas, since
the best outcomes will result from
embracing change that truly shifts the
focus towards people communities and
health as a movement for change.
Policy convergence?
“…the mandate to NHS England will make it a
priority to extend personal health budgets,
including integrated budgets across health
and social care.”
“As PHBs are extended beyond
the pilot sites…we will make it
straightforward for people to
combine them with personal
social care budgets so that they
can make the most of the
support to which they are
entitled.”
Interdependent, one will not work without the
other
Kings Fund: Building the House of Care
“people are
managing their
health on a day
to day basis,
but they may
need additional
help to develop
their confidence
in fulfilling their
role as a self
manager.”
The biggest
challenge for the
clinicians involves
recognising that
information and the
lived experience and
personal assets that
the patient brings to
the care planning, is
as important as the
clinical information
in the medical
record.”
Evidence?
National Personal Budgets Surveys, Think Local Act Personal 2013
Where could personal budgets fit with
integration?
• Personal health budgets could be deployed in all integration
plans, with the greatest impact coming from a risk stratified
approach targeting those with the most complex needs, e.g.
o Repeat acute mental health admissions in crisis.
o Repeat users of A & E with two or more long term conditions.
o Families and individuals who want an alternative to nursing/residential
care for frail older people.
o People who might become CHC eligible if not supported early.
• Personal budgets could also be deployed effectively at the point
of hospital discharge.
“70,000 beds days used in January 2014 alone, some 3,000 a day because people were stuck
in hospital despite being fit to leave.”
Kings Fund, Commission on Future of Health and Social Care in England. Interim report
2014.
Stay in touch with TLAP
Website: www.thinklocalactpersonal.org.uk
Twitter: @samhbenn @TLAP1