Here are a some links to interesting videos and a very clear report about integrated care for frail, elderly patients.
Professor David Oliver, consultant at Royal Berkshire Hospital comments on a patient's experiences where very common failings in care took place - see the video - produced under an initiative of Health Service Journal and Serco.
And here is the King's Fund's picture of how joined up care should work -Sam's story
Key to better care is determined cooperation by the local authorities and the CCGs - which has been notable in Reading where the Better Care Fund (health and social care integration) plans have been fast-tracked as a planning pilot for other areas. Also key is effective access to records between providers. At this moment community nurses in Reading are having to enter data separately into two or three databases. In order to speed discharge in Wexham Park hospital in East Berkshire a special team had to be established by Berkshire Healthcare Trust who had access to both the communithy and the hospital record systems so that they could manually read, compare and update. It has been effective - but we can do much better.
Five key points from the report attached below are:
- There is a myth that providing more and better care for frail older people in the community, increasing integration between health and social care services and pooling health and social care budgets will lead to significant, cashable financial savings in the acute hospital sector and across health economies. The commission found no evidence that these assumptions are true.
- The commonly made assertion that better community and social care will lead to less need for acute hospital beds is probably wrong. A short-term reduction in acute sector demand may follow as a consequence of community-based demand reduction initiatives, although this is unproven.
- We need more realism in the debate about the quality and quantity of care that can be provided in an environment of funding that is declining relative to demand. The pursuit of current NHS funding policies looks likely to lead to a funding gap. No major political party’s current health policy commitment will meet this funding gap.
- Hospitals should not be used to provide care that should more appropriately be provided elsewhere. Commissioners must improve community care to meet future demand, but the required investment must be based on evidence
- While acute hospital admission is often the right thing to do for frail older people, being in hospital also creates risks for older people.