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New Pilots Announced To Bring Health And Social Care Together, UK

Main Category: Public Health
Article Date: 02 Apr 2009 - 1:00 PDT

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Patients in 16 pilot sites will benefit from a trial to see how health and social care services can join together to increase quality of care, Health Minister Ben Bradshaw and Care Services Minister Phil Hope announced today.

The £4million scheme has been designed to look beyond traditional health and social care boundaries to explore how services for patients and service users can be improved. The scheme will then assess the benefits of different models of care and identify any best practice that could be used more widely.

Each site has developed new methods to help respond to particular local health needs. The health issues being tackled in each pilot include dementia, care for the elderly, substance misuse, chronic obstructive pulmonary disease and end of life care. The methods involved vary widely; they include partnerships, new systems and care pathways that span primary, community, secondary and social care.

The winners are:

Bournemouth and Poole Teaching PCT
Cambridge Assura Limited Liability Partnership
Church View Medical Practice, Sunderland
NHS Cumbria
Durham Dales Integrated Care Organisation
Nene Commissioning Community Interest Company
Newcastle Hospitals NHS Foundation Trust
Cornwall and Isles of Scilly PCT
NHS Norfolk and Norfolk County Council
Northumbria Healthcare NHS Foundation Trust
North Cornwall Practice-Based Commissioning Group
Principia - Partners in Health, Nottinghamshire
NHS Tameside and Glossop
Torbay Care Trust
Tower Hamlets PCT
Wakefield Integrated Substance Misuse Service

Health Minister Ben Bradshaw said:

"We know that patients with conditions like cardiovascular disease frequently have social care needs as well as health ones. This programme provides an opportunity for clinicians - working closely with the community more widely - to use their 'on the ground' knowledge to design services that are flexible, personalised and seamless. That way, people will get the integrated health and social care they need, all in one place, to help manage their condition effectively."

Care Services Minister Phil Hope said:

"I'm particularly interested to see how these pilots can benefit older people, particularly those with dementia. I know from talking to people with dementia and their carers that they get frustrated when trying to get the right health and care services for their loved ones.

"The pilot sites in Bournemouth and Poole, Church View Medical Practice and Cornwall and the Isles of Scilly are among those that will benefit older people and I want to see what lessons can be learnt from them in improving care for older people around the country."

The pilots start today and will run for two years. They will be evaluated over three years against a set of national and local measures, including impact on health outcomes, improved quality of care, service user satisfaction, and effective relationships and systems.

The winning 16 pilots have been selected after a rigorous assessment process, following over 700 expressions of interest and 100 applications. Although the pilots have designed new models for delivering care, they must also ensure that key features of the current health systems are safeguarded, such as choice, competition, and the role of the PCT as the commissioner of local health services.

The table below summarises each of the selected pilot organisations.

Integrated Care Pilots - pilot summaries

Bournemouth and Poole Teaching PCT


This pilot will be exploring a new model for delivering care for older people with dementia, involving collaboration between GPs, public sector organisations and third-sector services. It aims to provide a single point of access to an integrated community team.

Cambridge Assura LLP

This pilot will look at how different organisations across the health, social care and third sectors can better communicate and co-ordinate end-of-life care to enable people to be cared for and die in the place they choose. The pilot will also be improving public and patient engagement to ensure services are fully sensitive to user needs.

Church View Medical Practice, Sunderland

This pilot will improve quality of care and experience of services for the area's population of older people. The local acute trust and GP practice will work together as an integrated organisation, and will work in partnership with the PCT provider arm, social services and the patient practice group. The pilot will aim to provide an improved, personalised experience through active management of long-term conditions.

NHS Cumbria

This pilot will be exploring a new approach to helping patients with chronic diseases to manage their own care. It will be focusing on increasing the collaboration between GP and patient. It will aim to move care into a community setting and reduce hospital admissions.

Durham Dales Integrated Care Organisation

This pilot will involve seven partner organisations working together to meet the needs of a rural population, provide continuity of care and reduce health inequalities. It will explore a number of different care pathways aiming to improve planning information, move care into a community setting, increase patient/carer satisfaction and reduce hospital admissions.

Nene Commissioning CIC

This pilot will develop new models of long-term condition management to help patients remain independent for longer and have more choice in their end-of-life care. It will create personalised care plans for high-risk individuals and aim to reduce admissions to hospital.

Newcastle Hospitals NHS Foundation Trust

This pilot will provide an improved preventative service for over 60s at risk of falling by broadening the current falls and blackout (syncope) service provision. It will enhance provision and access to care and establish a network of community-centred training services led by clinicians, in partnership with the third sector and other agencies. By developing these community services the pilot aims to reduce the number of falls and admissions to hospital.

Cornwall & Isles of Scilly PCT

This pilot will unite primary, secondary, health and social care services by setting up a GP-led memory clinic supported by a team of practice-based case managers and dementia care advisers. It will seek to increase the number of people receiving an early diagnosis, reduce admissions to hospital and care homes and see people maintaining independent living for longer.

NHS Norfolk and Norfolk County Council

The focus of this pilot will be on integrating care services for the elderly. Joint working between the PCT and the County Council will identify people in need of support and then work with them to develop personalised care plans. It aims to help elderly people live fulfilling and independent lives and to form care plans that meet the needs of both patients and carers.

Northumbria Health Care NHS Foundation Trust

This pilot will be exploring a new approach to helping patients with Chronic Obstructive Pulmonary Disease (COPD) to manage their own care. The pilot will ensure providers work together to co-ordinate care, provide consistent information and education and help patients manage their own care (with assistance from their key worker).The pilot aims to increase patient satisfaction, reduce hospital admissions and reduce the length of stay in hospital when admission is required.

North Cornwall Practice-Based Commissioning Group

This pilot involves 10 GP practices in North Cornwall working together to integrate Mental Health community teams, based in a rural location, with a single point of access from GP practices. It will integrate Mental Health acute and social services. The pilot will aim to dissolve boundaries so patients can more easily navigate through the system and ensure they 'only have to tell their story once'.

Principia - Partners in Health, Nottinghamshire

This pilot is designed to help create more informed and empowered COPD patients. It will involve partners working together through two projects to identify 'at risk' patients, and work with teams in community wards and with other partners involved in COPD treatment to integrate care along the clinical pathway. It is designed to improve co-ordination of care, increase patient satisfaction and reduce hospital admissions.

NHS Tameside & Glossop

This pilot will be seeking to change behaviour amongst people at risk of CardioVascular Disease (CVD). It will involve developing partnerships to identify 'at risk' residents, supporting them with diagnosis/treatment but also promoting self-care and behaviour change. The aim is to reduce the risk of CVD (and reduce mortality rates for patients who have contracted it), improve the patient experience and reduce visits to Outpatient clinics.

Torbay Care Trust

This pilot will be integrating care for the elderly so that it is personalised and tailored to individual needs, secures best possible outcomes and ensures best use of resources. It will involve partner organisations across primary, secondary, social care and mental health services focusing on the whole care pathway, seeking to deliver high-quality, safe, and reliable services for patients across the spectrum of care.

Tower Hamlets PCT

This pilot will be helping patients with long-term conditions to manage their own care. It will help patients make their own choices, with support from a range of diverse services and specialists locally. It will aim to improve health and well-being for patients with long-term conditions, increase uptake of services from targeted hard-to-reach groups and reduce the expected trends in long-term conditions.

Wakefield Integrated Substance Misuse Service

This pilot will integrate care in the context of a substance misuse and social reintegration service for vulnerable people. It will involve a partnership of NHS, third sector and wider stakeholders and aim to make measurable improvements in the "care experience" for substance misusers, creating integrated pathways that are both personalised and cost efficient.

Source
Department of Health, UK




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