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Understanding Integrated Care
January 2013
IC3ML and the BCF
Recommendations

1: Find new services offerings beyond Telehelath and Telecare
2: Refine these services from around a theme of patient centred
care

3: Create new Services for Care-Coordination, Patient
engagement and Transitional Care

4: Understand how the new Integrated Care market as defined
by the LGA can be enabled by IC3ML technology partners

5: Work with H&W Boards to create the services they defined in
their Better Care Fund applications

6. Position IC3ML as an essential

support service that scales BCF
defined clinical practice in localities
UK Examples of Best Practice
Integrated Care
From LGA Toolkit for BCF
Integrated Care
Example: Torbay
Integrated Care Example:
Isle of Wight
Integrated Care
Example: NWL
Integrated Care Example:
Cumbria
Integrated Care Example:
Greenwich
Integrated Care Example:
Northamptonshire
Integrated Care Example:
North Devon
Integrated Care Example:
Waltham, East Lon & City
Integrated Care Example:
Greater Manchester
Integrated Care Example:
US: PACE
Integrated Care Example:
Germany: GK
Example services
could offer in
Integrated Care
Integrated Care:
LGA Examples
What technology services are required to make these
models a reality?
Create Services Across the
patient journey
Example cost savings in the
high priority areas
Savings from new Services:
Essex
What is the impact of integrating care?
For a population of 1,127,298 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £63m and a
net impact of £63m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

12m
51m
63m

20%

80%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

11m
11m
18m
18m
18m
11m
Savings from new Services:
Camden
What is the impact of integrating care?
For a population of 186,038 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £10m and a
net impact of £10m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
8m
10m

28%

72%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

2m
2m
3m
3m
3m
2m
Savings from new Services:
Havering
What is the impact of integrating care?
For a population of 191,565 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a
net impact of £11m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
9m
11m

23%

77%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

2m
2m
3m
3m
3m
2m
Savings from new Services:
Islington
What is the impact of integrating care?
For a population of 175,409 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a
net impact of £11m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
8m
11m

25%

75%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

2m
2m
3m
3m
3m
2m
Savings from new Services:
Merton
What is the impact of integrating care?
For a population of 159,986 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a
net impact of £11m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
8m
11m

25%

75%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

2m
2m
3m
3m
3m
2m
Savings from new Services:
Tower Hamlets
What is the impact of integrating care?
For a population of 207,864 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £14m and a
net impact of £14m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
11m
14m

23%

77%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

3m
2m
4m
4m
4m
2m
Savings from new Services:
Cambridgeshire
What is the impact of integrating care?
For a population of 506,635 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £28m and a
net impact of £28m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

5m
23m
28m

19%

81%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

5m
5m
8m
8m
8m
5m
Savings from new Services:
Kent
What is the impact of integrating care?
For a population of 1,174,947 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £70m and a
net impact of £70m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

14m
57m
70m

20%

80%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

13m
12m
21m
21m
21m
12m
Savings from new Services:
East Sussex
What is the impact of integrating care?
For a population of 433,006 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £24m and a
net impact of £24m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

5m
19m
24m

19%

81%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

4m
4m
7m
7m
7m
4m
Savings from new Services:
Brighton & Hove

What is the impact of integrating care?
For a population of 228,289 being the total population (excl. children); the impact of applying a
model of integration similar to NWL will be a gross reduction in commisioner spend of £13m and a
net impact of £13m.
The specific gross impact on commisoned services is caculated to be as follows:
Social Care
Mental Health
A&E
Non-Elective - Admissions
Non-Elective - Bed Days
Total

£
£
£
£
£
£

0%

3m
10m
13m

24%

76%

What is the relative importance of the main drivers of integrating care?
Gross Impact
Case management
Signposting & navigation
Effective crisis response
Improving transitional care
Effective ongoing support
Effective preventive care

£
£
£
£
£
£

2m
2m
4m
4m
4m
2m
Dr. M.J. Rice
Principal Consultant
Kokomo
www.kokomo.eu
London (44) : 074 387 89155
Dublin (353) : 086 823 1447

@malachyrice

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Understanding Integrated Care in England

  • 2. IC3ML and the BCF Recommendations 1: Find new services offerings beyond Telehelath and Telecare 2: Refine these services from around a theme of patient centred care 3: Create new Services for Care-Coordination, Patient engagement and Transitional Care 4: Understand how the new Integrated Care market as defined by the LGA can be enabled by IC3ML technology partners 5: Work with H&W Boards to create the services they defined in their Better Care Fund applications 6. Position IC3ML as an essential support service that scales BCF defined clinical practice in localities
  • 3. UK Examples of Best Practice Integrated Care From LGA Toolkit for BCF
  • 15. Example services could offer in Integrated Care
  • 17.
  • 18. What technology services are required to make these models a reality?
  • 19. Create Services Across the patient journey
  • 20. Example cost savings in the high priority areas
  • 21. Savings from new Services: Essex What is the impact of integrating care? For a population of 1,127,298 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £63m and a net impact of £63m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 12m 51m 63m 20% 80% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 11m 11m 18m 18m 18m 11m
  • 22. Savings from new Services: Camden What is the impact of integrating care? For a population of 186,038 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £10m and a net impact of £10m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 8m 10m 28% 72% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 2m 2m 3m 3m 3m 2m
  • 23. Savings from new Services: Havering What is the impact of integrating care? For a population of 191,565 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a net impact of £11m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 9m 11m 23% 77% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 2m 2m 3m 3m 3m 2m
  • 24. Savings from new Services: Islington What is the impact of integrating care? For a population of 175,409 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a net impact of £11m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 8m 11m 25% 75% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 2m 2m 3m 3m 3m 2m
  • 25. Savings from new Services: Merton What is the impact of integrating care? For a population of 159,986 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £11m and a net impact of £11m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 8m 11m 25% 75% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 2m 2m 3m 3m 3m 2m
  • 26. Savings from new Services: Tower Hamlets What is the impact of integrating care? For a population of 207,864 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £14m and a net impact of £14m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 11m 14m 23% 77% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 3m 2m 4m 4m 4m 2m
  • 27. Savings from new Services: Cambridgeshire What is the impact of integrating care? For a population of 506,635 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £28m and a net impact of £28m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 5m 23m 28m 19% 81% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 5m 5m 8m 8m 8m 5m
  • 28. Savings from new Services: Kent What is the impact of integrating care? For a population of 1,174,947 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £70m and a net impact of £70m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 14m 57m 70m 20% 80% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 13m 12m 21m 21m 21m 12m
  • 29. Savings from new Services: East Sussex What is the impact of integrating care? For a population of 433,006 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £24m and a net impact of £24m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 5m 19m 24m 19% 81% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 4m 4m 7m 7m 7m 4m
  • 30. Savings from new Services: Brighton & Hove What is the impact of integrating care? For a population of 228,289 being the total population (excl. children); the impact of applying a model of integration similar to NWL will be a gross reduction in commisioner spend of £13m and a net impact of £13m. The specific gross impact on commisoned services is caculated to be as follows: Social Care Mental Health A&E Non-Elective - Admissions Non-Elective - Bed Days Total £ £ £ £ £ £ 0% 3m 10m 13m 24% 76% What is the relative importance of the main drivers of integrating care? Gross Impact Case management Signposting & navigation Effective crisis response Improving transitional care Effective ongoing support Effective preventive care £ £ £ £ £ £ 2m 2m 4m 4m 4m 2m
  • 31. Dr. M.J. Rice Principal Consultant Kokomo www.kokomo.eu London (44) : 074 387 89155 Dublin (353) : 086 823 1447 @malachyrice