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Approaches to integrated care ‘too top down’, says health alliance

Vital to rebuild community trust if progress is to be made

Caroline White

Wednesday, 15 February 2017

Approaches to integrating health and social care have been “too top down”, while insufficient emphasis has been placed on rebuilding shattered community trust, contends the New NHS Alliance.

The recent report on health and social care integration, published by spending watchdog the National Audit Office, has bought into sharp focus just how important it is for organisations across health and social care to work more closely and cohesively together for the benefit of local communities and patients, it says.

The direction of funding needs to change so that it focuses on the benefits accrued to patients and throughput rather than on how much money the NHS can save, it insists.

“We believe that the various approaches taken to date in integrating health and social care have been too ‘top down’ – and this has been compounded by a perception that these approaches require big systems change,” comments chief executive, Merron Simpson.

“What has been missing is a willingness to empower both frontline staff and communities to work differently and find solutions to their health issues. We need to understand that change will come through a series of small changes. In terms of measurement of progress, we believe there needs to be a shift in mindset, with much greater use of measures that show health outcomes,” she added.

Chair Heather Henry, who works as a nurse with communities in Salford, said that while extra funding was urgently needed for social care, it was still possible to achieve better outcomes by closer working relationships among NHS bodies, local authorities, housing, the voluntary sector, and local communities.

“The NHS needs to recognise and address the damaged health and social care relationship dynamic within our communities. This is especially needed in those areas where relationships with health professionals are shattered. This can be due to a variety of reasons, such as lack of funding for promised projects or policy changes, but whatever the cause, the reality is that the local community is left high and dry. And bitter. And wary,” she said.

“Historically there has been a culture in the health and social care sector of ‘doing things to people’ rather than ‘with them’ – and this has been very apparent in the most disadvantaged areas.

“Trust has broken down in these communities – resulting in health and social care initiatives failing, and the most hard pressed residents being driven deeper into despair. It’s time to change our approach, break down the credibility barriers, improve patient experience, and rebuild community trust,” she added.

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