Population health management

How population health management will deliver a sustainable NHS | The Good Governance Institute | IBM Watson Health

Image source: http://www.good-governance.org.uk

This report explores the potential of population health management (PHM) to deliver a more sustainable version of the NHS by looking at what it takes to develop an integrated healthcare model, evaluating system maturity to embrace PHM, and drawing on case studies from both the UK and the US.

Full document available here

Integrated care systems

Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England |  Chris Ham | The King’s Fund 


NHS England has recently changed the name of accountable care systems to integrated care systems. In this updated long read, Chris Ham looks at work under way in these systems and at NHS England’s proposals for an accountable care organisation contract.

The article looks at the following:

  • Why is change needed?
  • What are integrated care and population health?
  • What’s happening with new care models?
  • What’s happening in integrated care systems?
  • What are ACOs and why are they controversial?
  • How are integrated care systems and partnerships developing?
  • What has this way of working achieved?
  • What do these developments mean for commissioning?
  • Are these developments really a way of making cuts?
  • Will these developments lead to privatisation?
  • Where next?

The author concludes that integrated care should be supported as it is the best hope for the NHS and its partners to provide services to meet the needs of the growing and ageing population.

Full article: Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England


Integrated care: impact on commissioning

Integrated care: what does it mean for commissioning?  | The Nuffield Trust 

This article looks at the risks and opportunities for commissioning as integrated care develops and evolves. Topics discussed include:

  • What are ACSs and ACOs?

  • NHS commissioning to date

  • The limited effectiveness of the market

  • Commissioning in integrated care systems

Additional link: Commissioning: the times are a changing

Strategic commissioning

CCGs in the UK should move towards strategic commissioning if the healthcare system is to embrace a move toward integrated local care, claims a new briefing from NHS Clinical Commissioners (NHSCC).

The publication brings out lessons based on evidence from the UK and health systems abroad. These are drawn from the perspectives of those implementing and developing policy around the new care models and from research of international models, primarily of high performing place-based systems of care that have developed in New Zealand, Sweden, Spain and the United States.

‘Making strategic commissioning work’ puts forward a number of recommendations aimed at easing the transition to strategic commissioning models.

  • The patient must be placed at the centre with a focus on quality – targets, payment incentives and prescriptive regulation have proved largely unsuccessful in driving system improvement and ensuring financial sustainability.
  • Clinical commissioning leadership and engagement must be retained – the evidence shows that success of population level planning is reliant on the engagement of clinicians in primary, secondary and community care, as well as the wider workforce.
  • National clarity on the ‘end state’ is essential – while local areas must lead the development of models for integrated health and care delivery, internationally, no system has been implemented without clear political consensus and a legislative framework to support it on an ongoing basis. In the UK, this could mean a national framework is needed – provided this is not too prescriptive to limit local development.

Full document: Making strategic commissioning work: Lessons from home and away

Accountable care

Accountable care: policy fad or step forward on the journey towards integrated care? | Nicola Walsh |The Kings Fund

Accountable care is under discussion almost everywhere in the NHS. Groups of NHS providers (sometimes with the local commissioner) are exploring how they can work more closely together to take on the responsibility for the health and care of a given population within a given budget. Currently, we are seeing emerging accountable care arrangements adopting various forms according to local needs and preferences: in some areas the focus is on creating a single organisation; in others, organisations are keen to use the words ‘system’ or ‘partnership’ – to reinforce the notion of working together.

In this Kings Fund blog, Nicola Walsh looks in more detail at Accountable Care Systems and partnerships.

Community hospitals and their services

The National Institute for Health Research has published Community hospitals and their services in the NHS: identifying transferable learning from international developments, scoping review, systematic review, country reports and case studies.

This study set out to understand better the role of different models of community hospital provision within the wider health economy and learn from experiences of other countries in order to inform the future development of community hospitals in England.

It concludes that at a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes.

Related: Community hospitals: a traditional solution to help today’s NHS? | HSJ

New report by @Localis ‏| Rebooting Health And Social Care Integration

This report finds that the health and social care integration agenda has a future but it is dependent on moving away from notions of structural integration and reliance on central policy direction | Localis

Image source: Localis

It concludes that the issue of funding and financial sustainability is critical but can only be influenced locally. The authors also believe that health and social care integration can create new value locally, but it must build on its most important point of consensus; greater person centred care. The report makes four strategic recommendations and six policy recommendations to support integration.