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New report promises ‘painless’ NHS reform

BMA says services can be integrated without major structural damage

Mark Gould

Monday, 06 August 2012

The BMA says its own set of guidelines and recommendations could help lead the integration of NHS services without the need for major structural or organisational change.

A new practical toolkit ‘Integrating Services Without Structural Change’ considers how doctors can work to integrate health and social care, and different parts of the NHS ‘virtually’.

The report by BMA policy analyst Sally Al-Zaidy looks at different methods of integration and considers the evidence for each model’s success or otherwise.

It provides practical tools for doctors involved in the integration process, including advice on: improving communication and relationships; asking the right questions; and improving coordination.

BMA council chair Mark Porter said the report would help improve doctors’ understanding of what integration could mean.

He said: “There is no single model for the best way of integrating health and social care but we want to help raise awareness of the opportunities for doctors — and if they want to help change services for the better, we can explain some of the tools to do that.”

The document puts healthcare integration into the context of recent health policy in England and considers what impact the new NHS structures being introduced under the Health and Social Care Act will have on integration.

Evidence for the whole range of integrated care models, from the Swedish ‘chains of care’ system, to virtual wards, to integrated care pathways, is examined in the report, which includes web links to more detailed data on each of the systems.

The report, published by the BMA health policy and economic research unit on Friday last week, is one of a series on integrated care. It says doctors can play a key role in improving communication and relationships, which are considered important whatever model of integration is used.

The report concludes that healthcare integration should not be looked at on its own, but as a vital part of wider healthcare policy.

It hopes that the new commissioning mechanisms being introduced to the NHS will not “cement further the systemic and relational barriers that will hinder the achievement of better integration of services in the NHS in the future”.

The report does not make recommendations on how far and wide integration should go in the NHS, arguing that such decisions should be taken locally.

But it says: “Any activity that seeks to strengthen cross-professional and organisational relationships through greater integrated working will serve the purpose of improving the quality and responsiveness of NHS services in the long-term, regardless of the commissioner and provider configurations of the day.”

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