Age UK’s Personalised Integrated Care Programme: Evaluation Of Impact On Hospital Activity

Nuffield Trust | February 2019 | Age UK’s Personalised Integrated Care Programme: Evaluation Of Impact On Hospital Activity

Age UK commissioned the Nuffield Trust to conduct a detailed evaluation of a scheme providing personalised care for older people. Given the severe pressure on health and care services across England, could this scheme help local systems by reducing the numbers of people being admitted to hospital in an emergency? 

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Image source: nuffieldtrust.org.uk

Read the full piece from Nuffield Trust

Download the publication Age UK’s Personalised Integrated Care Programme

 

Delivering effective governance and accountability for integrated health and care

NHS Clinical Commissioners | February 2019 | Delivering effective governance and accountability for integrated health and care

NHS Clinical Commissioners has released a new explainer for the NHS and local authorities outlines possible solutions for the governance and accountability challenges brought by the move to integrated health and care.

NHS organisations and local authorities are already working closely together to join up approaches to delivery and this will become even more important as the journey towards more integrated approaches to planning for health and care continues via ICSs, as set out in the NHS Long Term Plan earlier this year.

But we know from our members that there are several important differences in governance and accountability between the NHS and local authorities, which creates challenges when seeking to integrate systems and structures (Source: NHS Clinical Commissioners)

NHS Clinical Commissioners Download the explainer

Age UK’s Personalised Integrated Care Programme: Evaluation of impact on hospital activity

Nuffield Trust | January 2019 | Age UK’s Personalised Integrated Care Programme: Evaluation of impact on hospital activity

Age UK commissioned the Nuffield Trust to conduct a detailed evaluation of a scheme providing personalised care for older people. Given the severe pressure on health and care services across England, could this scheme help local systems by reducing the numbers of people being admitted to hospital in an emergency? (Source: Nuffield Trust)

Using data linkage the Nuffield Trust analysed the hospital use of 1,996 older people who had received a service from PICP in eight areas in England, and we compared their activity to that of a carefully selected control group. Their detailed analysis concludes – with some confidence – that it has almost certainly not been able to reduce costs or emergency admissions.

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Image source: nuffieldtrust.org.uk

While in some areas there was no apparent impact on hospital activity, overall there was a higher than expected use of emergency and outpatient services, and a corresponding increase in costs. These effects were detectable from the very start of the service and persisted for more than a year after.

However, the results suggest that the scheme may be identifying unmet need in the population, which manifests in greater use of hospital care (Source: Nuffield Trust).

The report- Age UK’s Personalised Integrated Care Programme – is available to download from the Nuffield Trust

Are patients benefiting from integrated care?

Nuffield Trust | January 2019 | Are patients benefiting from integrated care?

As QualityWatch publishes a scrolling data story investigating whether the drive in recent years to integrate services more closely has resulted in any tangible improvements for patients, Sarah Scobie puts the study in context and explains the findings. They find there is limited evidence that patients are benefiting from better integrated care: only one of the seven indicators has improved, three have deteriorated, and three show either no change or an inconsistent pattern (Source: Nuffield Trust).

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Nuffield Trust Are patients benefitting from better integrated care?

See also:

Quality Watch Are patients benefiting from integrated care? 

 

Leadership in integrated care systems (ICSs)

Social Care Institute for Excellence | November 2018 | Leadership in integrated care systems (ICSs)


The NHS Leadership Academy commissioned SCIE (Social Care Institute for Excellence) to undertake  research to further expand the understanding of systems leadership and leadership of integrated care systems. The research will inform the Leadership Academy’s long-term plans for supporting leaders in integrated care systems.

This Future of Care paper, aimed at chief executives, directors and senior managers from the NHS, local authorities, housing organisations and voluntary and community sector, is based on findings from interviews with systems leaders and a review of the literature (Source: SCIE).

 

Report available from  SCIE

See also: Free online webinar 

Ways of integrating care that better coordinate services may benefit patients

NIHR | December 2018 | Ways of integrating care that better coordinate services may benefit patients

In one of its latest Signals, the NIHR highlights a systematic review identified 267 pieces of literature from the UK and countries with a comparable economy, all published from 2006onwards, which analysed and described new models of integrated care. 

The review- funded by the NIHR-  looked at the international literature to understand how new care models may affect patients, providers and systems. Almost half of the 267 studies came from the UK. Most investigated integrated care pathways, often as part of a multicomponent intervention including multidisciplinary teams and some form of case management. Most studies focused on older people.

 

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The review finds some positives, but overall highlights the complexity of implementing and assessing new models of care. The reviewers found the complexity and variability of interventions across the literature, a hindrance in understanding the effect of specific changes. Most studies were at risk of bias, with few comparison studies as these are often not appropriate for organisational research (Source: NIHR).

Read the NIHR Signal in full here 

Published abstract here

 

 

Round two for STP plans: a fresh start or a dangerous distraction?

The King’s Fund | November 2018 | Round two for STP plans: a fresh start or a dangerous distraction?

Anna Charles, writing on The King’s Fund blog, discusses a recent letter
to Trust  chief executives and clinical commissioning group (CCG) accountable officers, NHS England and NHS Improvement confirmed that they ‘expect all sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) to develop and agree new strategic plans for improving quality, achieving sustainable [financial] balance and delivering the long-term plan.’  Charles writes that these will be developed during the first six months of 2019 and submitted for sign-off later that year. At the same time, one- year organisational plans will be submitted for 2019/20 (Source: The King’s Fund). 

Read the long read in full from The King’s Fund blog