This week is Integrated Care in Action Week and we, along with every other ‘integrated care system’ and other local areas in England have been invited to share what ‘integrated care’ means in practice.
Our partnership is for health and social care. That is what was so radical and ground-breaking in 2016. We committed to a deep integration, sharing decision-making and budgets, pooling staff and working in new ways based around the individual and not set by our organisational boundaries.
Our integration is not only with staff who wear an NHS or a council name badge, it’s also with the voluntary and community sector who do so much and are so effective in supporting people with their health issues.
And it’s with our wider public sector partners like Greater Manchester Police and the Greater Manchester Combined Authority which provides the community leadership that is essential to address health issues that cannot be dealt with by the NHS alone.
Witness our work on tackling rough sleeping. An alliance of public, private, third and faith sectors has come together under the Mayor of Greater Manchester A Bed Every Night initiative – cutting rough sleeping rates by 37% in a year.
In Bolton – just one example – nurses from Bolton NHS Foundation Trust work alongside volunteers from St John Ambulance and the Homeless Aid UK shelter to provide treatment and advice in privacy and dignity off the streets. “We can provide a much better service,” says nurse Sister Becci Lace.
Our way of working is based on a single, integrated, commissioning organisation for each of the 10 boroughs of Greater Manchester and a single, integrated, local care organisation on the same footprint.
The local care organisation is closely linked to other local public services such as schools, job centres, police and probation as part of a city region wide model of public services.
NHS, social care and others organise themselves into neighbourhood teams based on a local population of 30,000 to 50,000 people.
Led by GPs who understand the health needs of their patients best, they have unlocked a magic of job satisfaction and effectiveness through joint working.
The teams draw on a wide range of skills:
- Care coordinators/navigators
- Community safety advisors
- District nurses
- Early years workers
- Environmental health officers
- Family support workers
- Focused care workers
- Health visitors
- Housing officers
- Key workers/early help workers
- Mental health practitioners
- Neighbourhood beat officers
- Neighbourhood/community safety officers
- Police community support officers
- Social workers
- Substance misuse workers
- Voluntary and community sector workers and volunteers
“When we’ve asked people about their experience of working in an integrated neighbourhood team, they smile,” says Dr Doug Jeffrey, a GP and Manchester local care organisation Withington locality clinical director. “They are more effective at work.”
The personalised approach means services can be tailored to people’s individual needs and wants. Staff are empowered and people’s health, happiness and independence improves or is managed better.
We have numerous examples that bring this to life:
The team at Tameside who were able to help Geri regain her independence at home after a hospital stay and who even arranged for her to be able to cuddle a pet dog again
The team at Bolton who help Gladys manage the anxiety that hits her when she has breathing difficulties, contributing towards an astonishing 97% drop in this type of ambulance callout
The team at Trafford for whom helping Eileen sing karaoke at the local working men’s club is part of their focus on helping their residents lead fulfilling lives.
The GPs in Manchester who provide a direct phone line to Citizens Advice for help with the issues that are making people ill, such as debt, benefits or heating
Each borough has developed its own method of implementing a local care organisation and we have not been prescriptive in exactly how the model should work.
We do not pretend that this is a panacea for Greater Manchester’s deep-seated health inequalities, or even that it will, on its own, improve our performance against the NHS’s constitutional standards.
However, we are seeing that those areas that have the deepest integration and have made the most progress on this model are also the ones that have best stabilised the pressures they face in primary, secondary and community care.
For us this is not simply an initiative or the latest buzzword, it is fundamental to our approach and our mission to make the greatest and fastest improvement to health and wellbeing of the 2.8 million people of Greater Manchester.