Editorial

Editorial Peter Thistlethwaite Editor A significant government initiative in integrated Some commentators have come to the care has commenced this year in England, as conclusion that the whole programme is more many readers will know. The Department of about the future of the NHS than social care. It Health has approved 16 Integrated Care Pilots is true that it emerged from Darzi’s review of the across the country, all of which receive project NHS, and it is being led from within the so-called support, including some finance. Fuller details of World Class Commissioning initiative. Social these pilots are now more publically available, care has had a presence throughout in national in an Introductory Guide; see www.dh.gov. meetings, but not through its top leaders. A fly on uk/en/Publicationsandstatistics/Publications/ the wall at the most recent national get-together PublicationsPolicyAndGuidance/DH_106207. would have believed he was at an NHS session, You will observe that there is a wide range of with DH and Regional NHS speakers and a strong projects, from very small initiatives with a narrow ‘clinical’ voice demonstrating a key feature of focus based on GP surgeries (such as end-of- Darzi’s vision. On the other hand, perusal of the life care), to mainstream change across whole new Guide will confirm the presence of social communities (Norfolk, for example). Most are care or social work in a majority of the pilot organisationally conventional in their approach to projects, and many GPs there demonstrated a keen integration, linking primary care, community health understanding of the holistic approach necessary to services and social care, but others are being taken support people at home with long-term conditions, forward in innovative organisational forms. As an and recognise that their power as practice-based example of the latter, take Principia Partners in commissioners should enable them to shift Health in Nottingham; it sounds different, for a start, resources accordingly. Maybe the issue for social and is based on a social enterprise, with extensive care leaders is to develop more interest in the GP participation and strong user engagement. programme at all levels? There are clear partnership There is a strong emphasis in the pilots on opportunities, and they are well reinforced by the improving the management of long-term conditions, DH in the national events. which aim to strengthen teamwork in the community In the long run, it is the evaluation which is (horizontal integration), and in some cases to engage going to matter most. I can think of no similar hospital services to explore options for more vertical government-funded research into integration since integration. The most radical of these seems to the evaluation of the implementation of the Health involve incorporation of a GP practice into an NHS Act ‘flexibilities’ by a team from Manchester and Foundation Trust hospital in Sunderland, its entry in Leeds Universities at the millennium, which still the Guide stating as its aim: ‘... the proposed vertical stands as a key benchmark for progress. Almost integration of primary and secondary care to help a decade has passed, in which Care Trusts and remove current organisational and contractual barriers other highly developed partnerships have been in order to improve patient care.’ established without further empirical study – an This sounds almost iconoclastic in its ambitions: astonishing omission. The results of this new pilots do need to be encouraged to push away at evaluation will be awaited with considerable the boundaries. interest. 2 *OURNALOF)NTEGRATED#ARE6OLUMEs)SSUEs $ECEMBER¥0IER0ROFESSIONAL,TD http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Integrated Care Emerald Publishing

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
1476-9018
DOI
10.1108/14769018200900039
Publisher site
See Article on Publisher Site

Abstract

Peter Thistlethwaite Editor A significant government initiative in integrated Some commentators have come to the care has commenced this year in England, as conclusion that the whole programme is more many readers will know. The Department of about the future of the NHS than social care. It Health has approved 16 Integrated Care Pilots is true that it emerged from Darzi’s review of the across the country, all of which receive project NHS, and it is being led from within the so-called support, including some finance. Fuller details of World Class Commissioning initiative. Social these pilots are now more publically available, care has had a presence throughout in national in an Introductory Guide; see www.dh.gov. meetings, but not through its top leaders. A fly on uk/en/Publicationsandstatistics/Publications/ the wall at the most recent national get-together PublicationsPolicyAndGuidance/DH_106207. would have believed he was at an NHS session, You will observe that there is a wide range of with DH and Regional NHS speakers and a strong projects, from very small initiatives with a narrow ‘clinical’ voice demonstrating a key feature of focus based on GP surgeries (such as end-of- Darzi’s vision. On the other hand, perusal of the life care), to mainstream change across whole new Guide will confirm the presence of social communities (Norfolk, for example). Most are care or social work in a majority of the pilot organisationally conventional in their approach to projects, and many GPs there demonstrated a keen integration, linking primary care, community health understanding of the holistic approach necessary to services and social care, but others are being taken support people at home with long-term conditions, forward in innovative organisational forms. As an and recognise that their power as practice-based example of the latter, take Principia Partners in commissioners should enable them to shift Health in Nottingham; it sounds different, for a start, resources accordingly. Maybe the issue for social and is based on a social enterprise, with extensive care leaders is to develop more interest in the GP participation and strong user engagement. programme at all levels? There are clear partnership There is a strong emphasis in the pilots on opportunities, and they are well reinforced by the improving the management of long-term conditions, DH in the national events. which aim to strengthen teamwork in the community In the long run, it is the evaluation which is (horizontal integration), and in some cases to engage going to matter most. I can think of no similar hospital services to explore options for more vertical government-funded research into integration since integration. The most radical of these seems to the evaluation of the implementation of the Health involve incorporation of a GP practice into an NHS Act ‘flexibilities’ by a team from Manchester and Foundation Trust hospital in Sunderland, its entry in Leeds Universities at the millennium, which still the Guide stating as its aim: ‘... the proposed vertical stands as a key benchmark for progress. Almost integration of primary and secondary care to help a decade has passed, in which Care Trusts and remove current organisational and contractual barriers other highly developed partnerships have been in order to improve patient care.’ established without further empirical study – an This sounds almost iconoclastic in its ambitions: astonishing omission. The results of this new pilots do need to be encouraged to push away at evaluation will be awaited with considerable the boundaries. interest. 2 *OURNALOF)NTEGRATED#ARE6OLUMEs)SSUEs $ECEMBER¥0IER0ROFESSIONAL,TD

Journal

Journal of Integrated CareEmerald Publishing

Published: Dec 2, 2009

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