Integrated care was chosen as the focus of the workshop, as this is consistently emphasised in Department of Health and government policy, as offering the potential to improve coordination of care for patients, supporting people to remain healthy and avoid crises, while offering greater value for money. Looking to the future, the workshop offered participants the opportunity to envision how they might progress the idea of integrated care, imagining the impact of new roles, places or collaborations. Participants were people from different local organisations such as Help Direct, Health Trainers, Signposts, Medical Practice 1 (managers, doctors and nurses), Age Concern, Citizens Advice Bureau, Lancaster Adult Social Services, N-compass, Lancashire Link.
Activity one: Integrated care as it stands
Groups were formed around three key profiles of patients representing three main age groups. People in the groups were asked to suggest, starting from the patient situation, what care they, as individual organisations, could provide. After filling each individual contribution, existing links among organisations and services were identified together with barriers for integration of care.
All the groups clearly visualised in their maps the complexity of care assessment, ranging from housing, benefits, family and work situations to lifestyle, social isolation, mental health, diet, special treatments, etc. As an effect of this complexity, care has been described as provided in a discontinuous and disconnected way from both the patient and the staff perspective. Barriers mentioned were: lack of communication, of time, of feedback on care journeys and little understanding of each other’s activities and potential contributions to the patient.
Activity two: Integrating ideas
In the second activity each group was asked to move from thinking of what they could offer as individual organisations, to what patients really needed for their support. They were asked to imagine themselves as a working team to assess, plan and implement care based on the patient profile they were given. Each group identified key patients’ needs, imagined what kind of services could be provided for each of the needs and which vouchers could be spent to set up the new ideal system.
The three groups worked around three main ideas, which they developed:
- ‘one stop shop’ for general advice with new triage and health care roles
- individual health & social care budgets supported by a virtual care broker platform and common referral system
- individual iPad for health and social care information, supported by a new role, a ‘wellbeing coordinator’