European integrated care models weighed up by struggling hospital

Weston Area Health Trust, which was declared not clinically or financially viable in its current form, has begun talks with North Somerset Council, NHS Somerset, primary care provider North Somerset Community Partnership and clinical commissioning groups about creating an integrated care organisation to provide all health and social care in the area.

HSJ understands it is examining models of integrated care from Valencia in Spain and Jönköping in Sweden, as well as Torbay and Southern Devon Care Trust and Wye Valley Trust in Herefordshire.

Under the Valencia model the regional government pays a fixed price per inhabitant to a private contractor for primary and secondary care for a population of 250,000. The 15 year contract stipulates the company can make no more than 7.5 per cent profit. The model has been found to be 20 per cent cheaper than parts of the region that operate different systems, mainly because of reduced staff costs and the inbuilt incentive to avoid costly acute care.

Jönköping County Council, which funds and provides primary, secondary and social care for a population of 337,000, is consistently the best performing region in Sweden. It has a focus on patient pathways and continuous quality improvement through the creation of a central learning centre, boosting frontline staff skills, and financial incentives for leaders who improve quality.

Wye Valley Trust, formed under the transforming community services programme earlier this year, provides acute, community and social care for a population of 180,000 and is due to submit its foundation trust application to the Department of Health next year.

Torbay, one of the pioneers of integrated care, provides community healthcare and social care for a population of about 140,000. Its former chief executive Peter Colclough joined Weston in September to lead on integration work.

Weston had originally hoped to take on NHS North Somerset’s provider arm this spring but concerns over levels of activity and savings at the trust could not be addressed in time for the 1 April deadline. The services instead passed to the social enterprise North Somerset Community Partnership.

A trust spokeswoman said all “major stakeholders in the North Somerset health community” had agreed that the best way forward was to “develop innovative ways of providing integrated care”.

They would be examining the “options for future organisational form”.