NHS could be ‘best in the world’ if it integrates care, says expert

NHS could be 'best in the world' if it integrates care, says expert

Modernising and improving health service is a complex, risky but critical act of government.

Under current scrutiny is the push to shift the NHS to an Integrated Care System (ICS) in a bid to reverse the fragmentation of the system, which many commentators have argued is damaging to good health care and becoming increasingly expensive.

It has also been argued that the current system, with a core geographic approach, has led to escalating hospital admission numbers.

ICS advocates claim its holistic approach is not just about improving healthcare but is also more cost effective.

In 2010, Professor Don Berwick served as an advisor to US President Barak Obama, and in 2013 he carried out a review on patient safety in the NHS on behalf of Prime Minister David Cameron.

Prof Berwick, who has also served as a professor of health policy and management at the Harvard School of Public Health,  goes so far as to argue that an Integrated Care System would make the NHS “the best healthcare system in the world”.

He believes pooling the resources of health providers, including the social areas of councils, is the best approach to helping people live longer, healthier lives and, importantly, keep them out of hospital.

“I think the NHS probably has a better chance to truly integrate care than almost any other health care system in the world,” Prof Berwick said in an interview with NHS England.

“We are not our diseases, we’re not a broken arm or diabetes, we’re whole people who are making journeys through our lives and the care system has to honour that.”

Prof Berwick, founding CEO of the Institute for Healthcare Improvement and now advisor to the King’s Fund think tank, said the wealth of knowledge and expertise the NHS has could be more thoroughly and effectively utilised in an Integrated Care System.

Prof Berwick and other advocates for an ICS said that in an ageing population, a broader, co-operative, healthcare is vital.

Working with local government on housing and lifestyle, for example, would be vital in developing preventative approaches to healthcare.

“There’s no reason the NHS can’t have the best care in the world, why you can’t take an appropriate proportion of your efforts and move them upstream to the causes of illnesses and use social determinants to prevent illness,” Prof Berwick said.

A few areas of England have begun trialling a more Integrated Care System.

In the Frimley Health and Care System, in Surrey North East Hampshire and Berkshire, a combined approach is underway.

According to NHS England, single multi-disciplinary care teams have been established – made up of GPs, nurses, mental health professionals, therapists and social care providers – and are “helping people avoid crises and stem rising emergency hospital admissions for the first time in years”.

In Dorset they have created 10 “hubs” to coordinate or deliver a recently extended array of out-of-hospital services.

“We’ve gone from uncoordinated, fragmented care that was very unsatisfactory for patients, to wraparound care that takes into account the holistic needs of the patient,” Dr Karen Kirkham, a GP in Weymouth, described the Dorset model in a recent Guardian interview.

The entire NHS could be shaped by the outcome of these new systems.

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