Achieving integrated care: the need for digital empowerment

In this article, Knight and Burdett look at the complex challenges involved in integrating care systems as part of the NHS Long-Term Plan of 2019, and the importance of digitalising services and records for implementing this.

Successful implementation of integrated care in Slovenian primary care

For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.

Patient engagement, autonomy, access to mental care services – the case for integrated care in Crete

Access to comprehensive primary care (PC) services is imperative to address the complex biopsychosocial needs of patients with mental illness and their families, while it holds the potential to safeguard mental health and enhance resilience in communities. Integration of mental health and social care services in primary care has not yet been achieved, while access to such services for the mentally ill is still hindered by patient-, provider- and system-oriented barriers. Improving service integration, quality and access requires active engagement of patients and families in the design and planning of services.

Interprofessional collaboration, interdisciplinary approaches and sound deliberative processes are ...

Policy framework for building integrated care for TB patients in Romania: setting up the scene

Population Health Management in Diabetes Care: Combining Clinical Audit, Risk Stratification, and Multidisciplinary Virtual Clinics in a Community Setting to Improve Diabetes Care in a Geographically Defined Population. An Integrated Diabetes Care Pilot in the North East Locality, Oxfordshire, UK

Disparities in diabetes care are prevalent, with significant inequalities observed in access to, and outcomes of, healthcare. A population health approach offers a solution to improve the quality of care for all with systematic ways of assessing whole population requirements and treating and monitoring sub-groups in need of additional attention.

Collaborative working between primary, secondary and community care was introduced in seven primary care practices in one locality in England, UK, caring for 3560 patients with diabetes and sharing the same community and secondary specialist diabetes care providers. Three elements of the intervention included 1) clinical audit, 2) risk stratification ...

Primary care networks explained

The National Health Service (NHS) is the umbrella term for the publicly-funded healthcare systems of the United Kingdom (UK). Since 1948 they have been funded out of general taxation. There are four systems, one for each of the four countries of the UK: The NHS in England, NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland. They were established together in 1948 as one of the major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery a health service based on clinical ...

Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department

Developing community care models aims to satisfy the needs of patients’ in-home care comprehensively. This is crucial to decrease adverse events and prevent rehospitalization.

The growing burden of chronic diseases, patients experiencing fragmented care, and increasing demand for coordination across providers in the health and social sector correlates with the need for the integration of care. The starting point in developing an integrated care strategy should be identifying and assessing population needs.

Models of integrated care may enhance patient satisfaction, increase the perceived quality of care, and enable access to services. The term ‘new models of care’ refers to a ...

The long-term impacts of new care models on hospital use: An evaluation of the Integrated Care Transformation Programme in Mid-Nottinghamshire

In this briefing, the Improvement Analytics Unit – a partnership between the Health Foundation and NHS England and NHS Improvement – has found evidence that integrated care programmes have the potential to reduce hospital utilisation and that the best results are delivered when new ways of working start to become embedded.   

It is important that the analysis was?able to?look?at the impact of the programme?over such a long time. Integrated care programmes usually aim to reduce hospital admissions, however previous?evaluations?were not able to demonstrate?whether reductions in hospital use might begin to materialise over a longer period ...

“It’s Difficult, There’s No Formula”: Qualitative Study of Stroke Related Communication Between Primary and Secondary Healthcare Professionals

The proportion of people living with stroke is growing. In England, National Institute for Health and Care Excellence (NICE) Guidelines for stroke recommend that a person with suspected or confirmed stroke event is admitted to a specialist stroke unit, in order to receive required treatment promptly. Stroke rehabilitation follows, which involves providing stroke survivors with support and treatment from a multidisciplinary rehabilitation team. Stroke survivors’ transition from acute settings to rehabilitation can take place either in hospital, at home or the community.

One model of care is Early Supported Discharge (ESD), which offers community-based health and social care as an ...

Goal-Oriented Care: A Catalyst for Person-Centred System Integration

Person-centred integrated care is often at odds with how current health care systems are structured, resulting in slower than expected uptake of the model worldwide. Adopting goal-oriented care, an approach which uses patient priorities, or goals, to drive what kinds of care are appropriate and how care is delivered, may offer a way to improve implementation.