Making sense of integrated care systems, integrated care partnerships and accountable care organisations in the NHS in England

Kings Fund, 20th February 2018

NHS England has recently changed the name of accountable care systems to integrated care systems, which describes more accurately the work being done in the 10 areas of England operating in this way. Our updated long read looks at work under way in these systems and at NHS England’s proposals for an accountable care organisation contract.

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Reimagining community services: making the most of our assets

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Source: Kings Fund

The purpose of this research was to understand the current state of community services and to explore how the health and care system needs to change to enable these services to meet the needs of the population now and in the future.

Growing financial and workforce pressures are having an impact on the ability of community service providers to meet the needs of the population and to make a reality of the vision set out in the NHS five year forward view. Community services are often fragmented and poorly co-ordinated, and are frequently not well integrated with other services in the community. This results in duplication as well as gaps between teams delivering care.

There is a great deal of innovative work going on across the NHS and beyond to improve community-based care. This is mainly happening through innovative projects rather than system-wide transformations in care delivery. A radical transformation of community services is needed, making use of all the assets in each local community wherever these are to be found, breaking down silos between services and reducing fragmentation in service delivery.

The most promising possibilities in the short term are through sustainability and transformation partnerships (STPs) and accountable care systems (ACSs), where plans have already been developed to strengthen community services and improve population health. More work is needed to ensure that all STPs offer a credible basis for improving care for their populations and strengthening services in the community, drawing on the design principles set out in this report

Falls prevention: cost-effective commissioning

Public Health England, 15 February 2018

The return on investment tool pulls together evidence on the effectiveness and associated costs for interventions aimed at preventing falls in older people living in the community. The flexible Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user. All interventions are aimed at those aged 65 and over.

The tool comes with an accompanying report, which details how the tool was constructed and presents the main results.

The second report summarises the findings from a literature review carried out to identify cost-effective interventions.

Local authorities and Clinical Commissioning Groups (CCGs) can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.

Participation in exercise programme improves BMI of US school children

School children in the US, (n= 707) who participated in an short-term  exercise programme experienced  improvements in  their body mass index (BMI) scores,  significantly different than the comparison group. This group also had higher odds of being in a lower BMI category at follow-up; significantly different than the comparison group.

running-2837486_1920The 12-week initiative ran for an hour three times a week.  Each session started with a warm-up, followed by a running activity, and incorporated a skills-based approach to teach a new skill each week. During the cool- down session there was discussion on nutrition for pupils.

By the end of the the programme the child participants had better body mass index scores, than the non- participants in the control group.  There was also an additional benefit for those children who participated three times a week as their focus on schoolwork improved, and those who attended two sessions a week also had notable improvements in their mood and energy levels.

The full story can be read at Science Daily 

The journal article is published online and is available here 

Full reference: Whooten, R. C. et al. |Effects of Before-School Physical Activity on Obesity Prevention and Wellness | American Journal of Preventative Medicine | 2018|  doi:  10.1016/j.amepre.2018.01.017

Getting the best out of general practice

Rosen, R. | (2018) | Divided we fall: getting the best out of general practice| Research report| Nuffield Trust

The traditional model of general practice, sometimes called ‘medical generalism’, involves GPs developing a relationship with a patient, and understanding their social and family background. It can make them more able to decide when medical treatment is not helpful or necessary, and to manage patients safely outside hospital. This report asks what might be lost as doctors and patients are reallocated to services focused on easy access, such as walk -in centres. Are general practitioners at risk of losing the value this delivers to patients and the wider NHS? (Nuffield Trust)

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The report considers what GPs and national NHS bodies can do to get the best of both worlds.
It is available from the Nuffield Trust 

Communities and health

 

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This resource provides an overview of the different approaches to working with communities for improving health and illustrates the vital role that they have in improving health and wellbeing. The Kings Fund has produced this reading list for those who want to explore the topic of communities and health in more detail. 

The following questions and areas are examined:

  • What is a ‘community’?
  • What is the role of communities in improving health?
  • Health policy and the role of communities in health
  • Examples of community involvement in health

Full resource: Communities and Health | The Kings Fund

Police and Public Health Collaboration

Guidance in documents from Public Health England support the national consensus statement, ‘Policing, Health and Social Care: working together to protect and prevent harm to vulnerable people’. 

These papers showcase good practice between police and health colleagues within case studies,  identifies obstacles to collaboration and enablers.

cooperate-2924261_1920.pngThey have been developed to stimulate discussion and and to contribute to the evidence base that will help to shape future work programmes. They are intended as an information source for the wider public health system.

Further details can be found at Public Health England 

Both documents are available to download from Public Health below: