This study aims to examine and synthesise the evidence for non-clinical services on improving functional outcomes for young adults with mental disorders. Open access article - no login required
Young adults with serious mental illness (SMI) have poor physical health and high Emergency Department (ED) and hospital utilization. Integrating primary care into community mental health care may be an important form of early intervention. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This systematic review aims to identify the reported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs. Open access article - no login required.
This systematic review examines the effectiveness of community-based multidisciplinary integrated care strategies with general practitioner (GP) participation for community-dwelling older adults and describes the level of care integration in each study. Open access article - no login required.
This study assesses whether English local governments’ strategies for place-based health and equity help explain why some disadvantaged areas have better mortality trends than others. Open access article - no login required.
This study aimed to explore the acceptability of health and wellbeing conversations such as within the third and social economy sector, including their existence without specific training. Open access article - no login required.
The aim of this study, which was nested in a larger evaluation project, was to explore the experiences and perspectives of healthcare professionals to understand the implementation of a step-down IC service in Buckinghamshire, UK. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This rapid review synthesizes evidence about the experiences of users and providers of community-based accommodation services for people living with serious mental illness internationally to understand priorities for policy and practice. Open access article - no login required.
"We interviewed commissioners and service providers in six local areas to find out how they experienced the process of receiving additional funds, making plans, and delivering and monitoring the plans in winter 2022–23."
"Local heath and care systems lack a shared understanding of the causes of hospital discharge delays in their area and of the best ways of tackling them, says a report from The King’s Fund.
The report, Hospital discharge funds: experiences of winter 2022-23, looked in-depth at six health and care systems. The authors spoke to local authorities, integrated care system leads, acute trusts, Healthwatch and local care provider associations.
Despite system partners saying that relationships were good, the report finds they were often insufficient to develop a shared understanding of the causes of delays or to bring about meaningful, co-ordinated action to reduce delays."
In our work on Understanding integration, The King’s Fund and the Picker Institute developed a guide for health and care partners to come together to better understand and learn from the views and lived experience of people and communities, in the spirit of delivering genuinely integrated care. Centred around 10 principles, the guide was designed to help systems to work to co-ordinate services around what matters to people and communities.
Over the past year, The King’s Fund has been working with NHS England and the HOPE network to design and develop projects drawing on the principles and ways of working outlined in the guide. The HOPE network provides peer learning and support opportunities for leaders within NHS trusts with responsibility for patient experience.
This briefing focuses on how to improve access to out-of-hospital care, including GPs, social care, community services and community mental health services.
In October 2021 the government announced plans for new community diagnostic centres (CDCs) across England. The ambition was that these centres would provide people with increased and more convenient access to diagnostics tests, and would lead to earlier diagnosis and reduce pressure on hospitals. Two years on, with 127 centres open and 1,563,400 patients waiting for a diagnostic test as of the end of August 2023, how are community diagnostic centres getting on and what challenges are they facing?
In this paper the authors focus on one Discharge to Assess service and analyses the perspectives and experiences of those involved in its delivery within systemic analysis framework.
In this paper, the authors demonstrate that a utilitarian argument can be made for investment in better support for inclusion health groups despite their small size. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Services to keep children out of hospital, known as hospital at home or virtual wards, are set for a major expansion across the NHS after a string of successful pilot schemes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Specific Timely Appointments for Triage (STAT) provides a practical, low-cost, data-driven approach to tackling waiting times. This study demonstrates its effectiveness in paediatric therapy services and provides evidence for a ‘hub and spoke’ approach to facilitate implementation that could be provided at scale. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
ICB leaders need to ensure prevention is at the heart of ICSs’ mission and purpose, create opportunities for district councils to lead, and use district councils to trial new place-based projects.
the advent of integrated care systems is being seen as an opportunity to work more closely with the communities they serve. And yet, despite all this, work with people and communities, can still feel like ‘a nice to have’ rather than being core to the business of the health and care system. For those of us working on this agenda it can feel like pushing a rock up a hill.
The submission focuses on the main challenges facing community services in seven key areas:
the profile and understanding of the sector
funding
reorganisation
workforce shortages
primary care networks and community services
learning from the new models of care programme
Jordan Reid sat down with Caroline Rollings, wellbeing lead for the National Association of Primary Care, to find out about the work she’s been doing to support staff wellbeing in primary care.
The much-anticipated Hewitt Review into the oversight, governance and accountability of integrated care systems (ICSs) landed last week, to surprisingly little fanfare and a somewhat muted reception. To anyone that has followed the path of the review since its launch in November 2022, it will come as no surprise that it is both comprehensive in its breadth and that it draws on extensive engagement with the sector and key partners, for which the review team and its leadership should be given due credit. Reflecting this, the final document weighs in at a hefty 89 pages. So, standing back from the detail, what are the key take-aways?
The debate about whether general practice should be organised through an independent contractor model (GP partnerships) or whether it should be provided by staff salaried within an NHS organisation is as old as the NHS itself.
This report provides an overview of the key actions required to tackle barriers and challenges to better partnership working between integrated care systems (ICS) and the voluntary, community and social enterprise (VCSE) sector. It identifies ways of working that can help mitigate barriers and facilitate solutions, and systemic actions that can help embed and spread good practice.
As we publish our new report on addressing barriers to partnership working with the voluntary, community and social enterprise sector, Helen Gilburt takes a look at three fundamental principles needed to create change.
Lancashire and South Cumbria Integrated Care System (ICS), like many ICSs across England, wants to improve population health and tackle inequalities. Having articulated this aspiration and set up a Population Health and Health Equity Academy in May 2022, in partnership with The King’s Fund, it has taken the first steps to making this a reality by developing its primary care workforce. In this long read, we outline key aspects of the approach taken in Lancashire and South Cumbria, and share reflections that may help others undertaking a similar journey.
Aim: To determine the feasibility of a nurse-led, primary care-based comprehensive geriatric assessment (CGA) intervention.
To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
In the past six months, there has been a rapid increase in the number of people experiencing delayed discharge from hospitals in England, with the number of patients remaining in hospital overnight who no longer meet the criteria to remain averaging 13,771 in February 2023. That’s up from 12,589 on average in April, an increase of 9.4 per cent.
Patricia Hewitt’s independent review of integrated care systems (ICSs) is aimed squarely at one of the biggest challenges facing ICSs – the strong culture of top-down performance management in the NHS. The reforms introduced by the 2022 Health and Care Act, with their focus on collaboration across boundaries in local systems, represent a direct challenge to this hierarchical culture, and without a new approach to accountability in the NHS there is little hope of ICSs living up to their original promise.
Social prescribing (SP) enables healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. We synthesised the evidence to understand the effectiveness of SP for chronic disease prevention. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Homelessness, reoffending, addiction and poor physical and mental health are intrinsically linked, with each often the cause and effect of the other. With this in mind, partners across Hampshire and the Isle of Wight Integrated Care System (ICS) are looking at the link between reoffending and health and the role partner organisations, such as the Office of the Police and Crime Commissioner, have to play in health inclusion.
Integrated care systems (ICSs) were established to create partnerships for population health, not simply to better manage existing patterns of NHS care. In many systems, statutory status has been accompanied by the creation of director, or similar, roles with titles that include population health. Roles intended sometimes to stimulate a reframing of work across the whole leadership team but elsewhere simply leading a standalone programme of work, often primarily analytical. How these emergent roles develop matters.
The aim of this study was to explore the experiences of first contact physiotherapists in primary care in south east Wales regarding the implementation, interprofessional collaboration and the facilitators and barriers to providing the service. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
In this article, the authors discuss the challenges associated with effective transition and describe their experience of implementing a healthcare transition pathway using a quality improvement model. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This commentary is a response to three articles on integrated care systems in this journal. It explores some aspects of the latest transformation of England's National Health Service (NHS) and raises some questions on the extent to which the proposed NHS Long Term Plan can deliver on the current challenges. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Blog post. The bold ambitions of integrated care systems (ICSs) to improve population health and tackle health inequalities, coupled with greater integration of health and care services, should definitely be a golden opportunity to do things differently and better. However, if ICSs want to prove that this is indeed a new era, they will need to act quickly to involve groups experiencing marginalisation and discrimination, including Disabled people.
Toby Lewis argues that we need to shift the debate about regions in health care from a vertical discussion within the NHS to a horizontal conversation about embedding the NHS in the wider world. If reducing health inequalities is to be the common purpose it ought to be, these new regions can play a crucial role.
Health and care systems can mitigate, reduce and prevent poverty’s effects on health, but to do this they need to be much better at sharing and acting on data. Our long read with the Centre for Progressive Policy sets out the data available, explores existing good practice, and what needs to happen next.
Place-based partnerships are collaborative arrangements between organisations responsible for arranging and delivering health and care services and others with a role in improving health and wellbeing. They are a key building block of the integrated care systems (ICSs) recently established across England and play an important role in co-ordinating local services and driving improvements in population health.
The aim of community diagnostic centres (CDCs) is to deliver additional diagnostic capacity in England by providing quicker and more convenient access for patients and reducing pressure on hospitals.
An opportunity but also a challenge for newly created integrated care systems (ICSs) is how to best engage with adult social care to deliver on ambitions to support the health, wellbeing and independence of their populations, addressing workforce challenges and designing integrated, person-centred services. It was for this reason that NHS England asked The King’s Fund to explore with adult social care providers their hopes and expectations for integrated care systems, their current level of engagement in ICSs and what could be done to improve involvement.
New community diagnostic centres may struggle to live up to ministers’ promises to improve access to services and reduce the NHS backlog, warns a new briefing on NHS diagnostics from The King’s Fund.
Community-based programmes can support healthcare systems by delivering preventive services and health promotion. This study aimed to determine the nature, range, and extent of theoretical models that guide the development of linkages between healthcare settings and community programmes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The objective of this article is to explore the role of the ‘Voluntary, Community and Social Enterprise’ (VCSE) sector in integrated care systems. In particular, the paper aims to examine recent experiences of the voluntary sector in responding to the Covid-19 pandemic, and the lessons that can be learnt for integrated care provision. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
In the United Kingdom (UK), link worker social prescribing has emerged as an option to improve long-term condition management and address primary care patients' non-medical needs by linking patients with community-based activities and support. This study aimed to identify and categorise the components of link worker social prescribing schemes in the United Kingdom. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
[Report] To explore how local authorities make improvements and measure success, and what type of support they use to make improvements, we conducted 27 interviews with those involved in improving adult social care in local authorities. We explored the adult social care improvement ‘stories’ in five local authorities and compared what we heard with established approaches and principles of quality improvement used in many sectors.
The recent Fuller stocktake report offered a snapshot of the state of play in general practice, and set out some next steps that could be taken to better integrate the different strands within primary care – harnessing the opportunities developing integrated care systems (ICSs) might bring. The report was accompanied by a literature review (302.81 KB, pdf) by The King’s Fund that set out the evidence base for what actually works when it comes to driving change and improvement in the sector.
This rapid realist review aims to explain how and why person-centred care (PCC) in primary care works (or not) among others for people with low health literacy skills and for people with a diverse ethnic and socioeconomic background, and to construct a middle-range programme theory (PT). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Social prescribing (SP) has rapidly expanded over recent years. Previously a bottom-up, community-led phenomenon, SP is now a formal part of structured NHS policy and practice. This study was designed to ascertain how general practitioners and other primary healthcare professionals (HCPs) within one clinical commissioning group (CCG) perceive and engage with this new NHS model. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
NHS England’s guidance is clear that clinical director roles in PCNs can be held be GPs, general practice nurses, clinical pharmacists or other clinical professionals working in general practice. So why might it be that primary care leaders aren’t more professionally diverse?
Social prescribing has been around for many years, and link worker roles were one of the first to be funded through the ARRS scheme. These link workers represent a real investment in non-clinical roles and the social model of health care, in general practice. They support patients who attend primary care with challenges such as access to healthy food, poor housing and financial issues, which have been strongly linked to poor health and avoidable deaths.
Voluntary and community sector organisations are increasing their role in supporting primary care services through ‘social prescribing’. Our findings, while focused on the parkrun practice initiative, are likely to have relevance to other collaborations between primary care and voluntary and community sector organisations. To read the full article, log in using your NHS OpenAthens details.
In this study, we consider the extent to which co-location is an enabler for service integration by examining multi-professional community care teams. To read the full article, log in using your NHS OpenAthens details.
In Ireland, the primary care mental health service has been recently enhanced through the employment of Assistant Psychologists (AP) in primary care psychology. This paper provides an early and brief evaluation of the impact of the AP-enhanced model through a tripartite approach to evaluation which utilises measures of throughput, output and stakeholder satisfaction. To read the full article, log in using your NHS OpenAthens details.
Today Minister for Equalities, Baroness Williams, congratulated Woolstone Medical Centre, based in Lewisham, for spearheading a new programme which trains GPs and staff in primary care organisations to fully support LGBT patients.
All prescriptions across England will be digitised to make staff and patients’ lives easier, Primary Care Minister Jo Churchill has announced today.
The electronic prescription service (EPS) will be rolled out nationally next month, following rigorous testing involving 60 GP practices and hundreds of pharmacies.
Almost 70% of all prescriptions are already being prescribed and dispensed through EPS and there has been positive feedback from GPs and pharmacies. Once the roll-out of the final stage is completed, nearly all prescriptions will be sent electronically.
Over time, we have become concerned that some providers of online primary care are configuring services in ways that take them out of scope of some or all UK regulators. This means they are not legally subject to the same inspections and safety checks
This guidance is for commissioners, public health directors and others involved in the local planning and provision of services and interventions that support people with cardiovascular disease (CVD) conditions.
Public Health England (PHE) collates and analyses available CVD data and produces intelligence resources to help with improving services and outcomes. This guidance supports health professionals with using these resources to make or influence decisions about local services.
The 15 actions prioritised in this resource draw on evidence about what works from international research, emerging best practices and engagement with our own stakeholders and partners. The actions are deliberately aligned with national policy, legal frameworks and regulatory guidance, but most important, they allow for local variety in system design and service delivery to flourish.
A psychological treatment service working in GP surgeries in Nottingham offers hope to people other services can’t help and has already saved more money than its staffing costs in its first year, according to research published today by Centre for Mental Health with the NHS Confederation Mental Health Network.
A new approach to complex needs, by Nick O’Shea, reports on the Primary Care Psychological Medicine service in Rushcliffe. The service offers psychological interventions to people who have high levels of unexplained or persistent physical symptoms of illness. Persistent physical symptoms can be painful, life-limiting and distressing. This can mean multiple GP appointments, outpatient visits and emergencies.
This online consultation toolkit is an interactive document that provides a range of ideas and options for different professionals, including clinicians, at different points in their implementation journey.
xtended appointments with mental health experts from the NHS, social care and specialist third sector organisations, plus access to therapies, physical health checks and pharmacists, are just some of the wider expertise patients will be able to access in their local GP practice and in the community under new ways of working. Patients will be able to explore the situation affecting their wellbeing – whether that is an ongoing mental or physical health problem, loneliness, debt, or other issues. They can then be guided to appropriate resources that may help, including talking therapies, benefits advice, or an introduction to a local community group.
A trial of new partnership working arrangements is taking place around intermediate care in Barnsley.
Home First is a collaborative piece of work between Barnsley Hospital, neighbourhood rehabilitation/crisis response team (intermediate care), re-ablement and social services.
The main aims are to get patients out of hospital quicker and in a better condition as well as freeing up the urgent care therapists time in the acute setting so they can prevent patients who require a longer stay deconditioning.
Patients in north Staffordshire are benefitting from advancements in digital technology being used to connect patients with GPs at the click of a button.
The ‘Skype to Care Home’ programme aims to link care home residents and primary care clinicians by conducting video consultations through medium of Skype. There are currently 16 care homes and 12 GP practices in north Staffordshire taking part in the programme.
Pharmacists are set to offer rapid detection and help for killer conditions like heart disease as part of a major revamp of high street pharmacy services.
The high street heart checks are part of an ambitious target the NHS in England has set itself as part of its Long Term Plan to prevent tens of thousands of strokes and heart attacks over the next ten years.
The new NHS Community Pharmacist Consultation Service will offer local pharmacy appointments to anyone calling NHS 111 about minor conditions such as earache or a sore throat.
If testing is successful, GPs and A&E will also start to refer patients to the service over the next 5 years.
Patients will continue to have the option to see their GP or attend A&E if they want to.
One of the aims is to make better use of pharmacists’ skills, as pharmacists receive 5 years of training, giving them expert knowledge of medicines and drug interactions.
This guidance is for NHS providers, including immigration removal centre (IRC) healthcare staff. It explains the entitlements and access to NHS care for people who are leaving an IRC and moving into the community.
This guidance covers the arrangements for England. Information about the provisions in Scotland and Northern Ireland can be found in Annex 2.
The report, based on 22 effective HWBs across the country, shows the boards are driving health and social care integration and making sure that prevention is at the heart of this - helping to keep people well in the first place, rather than managing ill health better.
This briefing places PCNs in the context of previous changes to general practice funding and contracting. It examines the rationale for networks, explores relevant evidence and draws out intended benefits and possible risks for the future of PCNs.
From this week groups of GP practices across Staffordshire and Stoke-on-Trent are formally committing to working together so that they can better serve patients.
They will be joining together as Primary Care Networks (PCNs) – with each PCN typically serving 30,000 – 50,000 patients.
Working together brings economies of scale and potentially allows a wider range of services to be offered.
Dr Asif Ahmed, GP in Staffordshire and Clinical Director for Stafford South PCN said: “PCNs have been mandated by the NHS Long Term Plan, however they provide an invaluable opportunity for practices to work together to deliver healthcare in a new combined way that will benefit all of the population. We have worked hard and negotiated with our practices to ensure that there is 100 per cent coverage for our patients to have access to a PCN.
Dr Nikita Kanani, NHS England and NHS Improvement’s Medical Director of Primary Care, describes the changes that will underpin safety improvement in primary care.
Patients are set to get longer appointments with their family doctor thanks to new ways of working which start today.
Practices large and small will work to support each other and deliver a wider range of specialist care services for patients from a range of skilled health professionals.
Around 7,000 practices across England – more than 99% – have come together to form more than 1,200 Primary Care Networks.
GPs will recruit multi-disciplinary teams, including pharmacists, physiotherapists, paramedics, physician associates and social prescribing support workers, freeing up family doctors to focus on the sickest patients.
Could schemes aiming to increase the availability of primary care health care access out of hours improve the overall quality of services and patient experience in outer east London? The Nuffield Trust was commissioned by Barking, Havering and Redbridge CCGs to evaluate the impact of access programmes in these boroughs.
The deadline for GP practices to agree their primary care network boundaries with local commissioners has now passed and the first money is due to flow to the new networks from July. As the dust begins to settle on decisions over membership, boundaries and leadership of networks, attention will now turn to delivery.
The steps between receiving a query or referral and allocating it to the right team is shown below. In this resource, we have referred to this as the 'access process'. Getting this process right can improve waiting times, patient flow and quality of care.
More than 50,000 people have taken charge of their own care after being handed control of how their NHS funding is spent.
Personal Health Budgets can be used to purchase personalised wheelchairs, assistance dogs and respite care to manage complex health problems, as well as tech devices that can control curtains, lighting, heating and door intercoms to help people live independent lives.
The rollout of the Budgets across the country is two years ahead of scheme and being ramped up further as part of the NHS Long Term Plan.
New figures published today by NHS England and Improvement show 54,143 people with long-term health problems, including disabled people and those with long-term physical and mental health conditions, are currently benefiting from them.
NHS doctors and nurses are using Skype to help older people get faster care, reduce avoidable ambulance call-outs and help people stay out of hospital.
The on-call Skype NHS team takes around 8,000 calls a year from wardens working in sheltered accommodation, care home staff and community teams looking for expert support for their residents.
Scheme running in Tameside (Greater Manchester).
An end to the standard 10-minute GP consultation to allow family doctors to spend more time with patients with complex needs is core to the Royal College of GPs' vision for the future of general practice.It states that by 2030 face-to-face GP consultations will be at least 15 minutes, with longer for those patients who need it.
A new report from the Royal College of Nursing (RCN) and Queen’s Nursing Institute (QNI) calls for urgent investment in District Nursing, as new figures show the number of District Nurses working in the NHS has dropped by almost 43 percent in England alone in the last ten years. As a result, there are only some 4,000 District Nurses providing care for a population of around 55.8 million in England, a ratio of only one District Nurse for every 14,000 people. This compares with one GP for every 1,600 people.
Open access. The Primary Care Patient Measure of Safety (PC PMOS) is designed to capture patient feedback about the contributing factors to patient safety incidents in primary care. It required further reliability and validity testing to produce a robust tool intended to improve safety in practice.