Integrated care in Trafford: progress to date


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Integrated care in Trafford: progress to date

  1. 1. Integrated care in Trafford:progress to dateNovember 2011 © Nuffield Trust
  2. 2. The Trafford integration story• Working for > 3 years to develop integrated care• Rising demand: older population, long-term conditions• Financial issues create a ‘burning platform’• Sept. 2008: ‘Clinical Congress’, to engage with care professionals• 2008–10: strategic development/SHA rejects plans• Focus on developing integrated service system• 2011: on-going development of a community-based ICO © Nuffield Trust
  3. 3. Principles used to guide the development of an integrated caresystem for Trafford1. ‘Nothing about me, without me’ – the patient voice must be at the heart of all provision2. General practice should be the ‘locus of integrated services’3. Specialist expertise is an essential component of effective integrated services4. The delivery of integrated services will rest primarily on extended roles for nurses and AHPs5. Integrated services must incorporate social care6. Future integrated services should bring together the full range of primary care services © Nuffield Trust
  4. 4. Overview of Trafford’s integrated governance arrangements
  5. 5. Overview of the emerging integrated care organisation in Trafford
  6. 6. Putting patients at the heart of integrated services in Trafford
  7. 7. Six mechanisms for engaging patients and the public in integratingcare in Trafford1. Assessing public/patient opinion2. Developing Patient Congress events3. Recruitment of patient representatives4. Developing a programme of accessible community engagement events5. Supporting the establishment of GP-attached patient forums6. Tracking patient experiences © Nuffield Trust
  8. 8. Key clinical engagement activities in Trafford• Engaging clinicians in developing integrated care• Leading service redesign• Developing local clinical leaders• Engaging vanguard (early adopter) practices © Nuffield Trust
  9. 9. Designing integrated services• Six multidisciplinary clinical panels selected in April 2010: • Clinical services (diabetes; respiratory; mental health and learning disability; ear, nose and throat) • Whole system’ areas (unscheduled and end-of-life care)• Bringing together consultants, GPs, specialist nurses/AHPs and social care staff• Supported by patient representatives, project managers and facilitators• Underpinned by quality improvement methodologies © Nuffield Trust
  10. 10. Overview of the work of the diabetes clinical panel
  11. 11. Plans for closer working across health and social care in Trafford• Continue to work with adult social services• Develop a formal joint partnership• Sustain the benefits of an integrated ‘virtual’ organisation• Align work on telehealth• Work with the evolving local authority public health team• Contribute to the work of wider stakeholders © Nuffield Trust
  12. 12. Overview of data sharing arrangements
  13. 13. Integration challenges in Trafford1. Recognise that major change is needed2. Put patients at the centre3. Engage with stakeholders when developing integrated systems4. Facilitate effective local leadership5. Focusing on improving quality and efficiency © Nuffield Trust
  14. 14. Lessons from Trafford’s integration journey• Ensure a clear and agreed vision• Work simultaneously with commissioners and service providers• Make a clear case for change and the journey towards integration• Be realistic about the pace of change• Ensure high-level support for integration• Secure senior staff time to ensure effective and ongoing engagement © Nuffield Trust
  15. 15. Lessons from Trafford’s integration journey• Actively engage clinicians across primary and secondary care• Make integrated care attractive to all clinicians• Ensure space and time to build a relationship• Engage social services from the outset• Use appropriate language © Nuffield Trust
  16. 16. Lessons from Trafford’s integration journey• Acknowledge the integral role of existing and emerging boards• Promote integrated care thinking amongst senior executives• Actively develop and support local leaders• Be clear about the role and activities of each of the stakeholders within an integrated care system• Use data systems, intelligence and information sharing to deliver integration• Use technology effectively © Nuffield Trust
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