Service integration is key for patient care

More integrated care, based around the person, is a goal being aimed at right across the healthcare sector, but is one that is proving difficult to achieve. Claire Murdoch, chief executive at Central and North West London NHS Foundation Trust, believes that input from people with the most experience of working in many of the more integrated systems are currently being excluded from the current debate. She said that, in many areas within the healthcare sector – such as children’s services, or HIV and sexual health – cost demands are actually resulting in a move further away from integrated care and towards keeping each of the institutions and organisations financially viable. By way of explanation she said: “A lot of money is going to local authorities for public health, such as some addiction and sexual health services. However, if you are a major provider of sexual health services, for example, you want to deliver integrated sexual health services. If somebody comes in for a contraceptive appointment, you might want to be able to test for HIV and other blood borne viruses. It is important to have a tariff and a set of commissioners that are going to support that integration around the person. I think it is cheaper and leads to better outcomes.”

Claire Murdoch explained that the London borough of Camden has seen success stories regarding integrated services when each part of the sector is given a chance to be the system integrator. “The Royal Free Hospital, for example, is the system integrator around diabetes care in Camden and this includes working with the local authority across a long-term condition pathway.”

Emergency services