Records ‘needed for integrated care’

Two think-tanks that are well-known for influencing government policy have called for a major investment in IT to promote integrated care.

In a report for the Department of Health and the NHS Future Forum that was issued this morning, the King’s Fund and the Nuffield Trust identify the lack of a “robust, shared electronic record” as one of the key barriers to creating integrated health and social care services.

It says “innovative approaches” are needed to sharing data, but the DH should “seek a streamlined approach to the governance of data sharing that can be applied across England, to avoid this becoming a waste of taxpayers’ money.”

Policy makers have argued that there is a need to join up or integrate health and social care for many years, to improve services for patients and to use resources more effectively.

The issue returned to public prominence last summer, when the NHS Future Forum said it wanted to see integration put at the heart of the government’s health service reforms.

Both the King’s Fund and the Nuffield Trust also argued that giving patients a choice of integrated services would be a more sophisticated and effective kind of choice for patients than choice of elective treatment.

The latest paper from the two-think tanks says the DH subsequently approached them for help in developing a national strategy on integrated care, and for ideas to feed into the ongoing work of the NHS Future Forum.

It argues that integrated care can be delivered “without further legislative change or structural upheaval” as long as it is stated as a clear goal for the NHS and local government – and given the same priority as imperatives such as delivering the 18 week referral to waiting time target.

“Improving integrated care should be seen as a ‘must-do’ priority to ensure it receives the attention needed,” it says.

Alongside this, the paper argues that patients with complex needs should be given an entitlement to a care plan, a name case manager responsible for co-ordinating their care, “access to telehealth and telecare” and a personal health budget.

And it says that a number of barriers to integrated care must be removed. In addition to the lack of an integrated electronic record, the paper says these include “risk averse” NHS management, the “persistent weakness” of commissioning, the divisions between secondary, primary and social care, and government policies on choice and Payment by Results.

The think-tanks argue that GP practices should be prepared to “operate at a scale that can provide the platform for integrated care”.

They also urge the government to agree new payment incentives and local currencies to reward integrated care initiatives.