Integrated care needs 'ambitious' target to succeed, DH told

A “clear, ambitious and measurable goal” akin to the 18-week target is needed to ensure the delivery of integrated care is viewed with the same importance as waiting times, Chris Ham has told HSJ.

Setting this goal is the central recommendation in a new government commissioned report, written jointly by the King’s Fund and the Nuffield Trust. Their conclusions, along with those of the NHS Future Forum’s integration workstream, will feed into a proposed national strategy for integrated care.

Speaking to HSJ ahead of the report’s publication today, Professor Ham said there had previously been “a lot of warm words” on the need for integrated care to improve services for patients with long term conditions.

But he said efforts to establish it widely were likely to “fall short” without a national goal.

Professor Ham acknowledged that measuring integration would be “quite difficult” but suggested it should be based on some form of measure of patient experience.

He said: “By 2015 every health economy should be able to demonstrate high levels of care coordination or integrated care.”

Based on his discussions with the Future Forum, Professor Ham said he expected them to make “very similar” recommendations next week.

“I can’t predict what their report will say but I would be very surprised if their recommendations were a million miles away from ours,” he said.

He added that the “government would be in a difficult position” if it chose to ignore calls for a national goal, should it be recommended by both groups.

To reinforce the target, Professor Ham said patients with complex needs should be offered “guarantees” that should include an entitlement to an agreed care plan, a named case manager, access to telehealth and a personal health budget.

It added that “financial incentives are needed to support rather than inhibit organisations working together around the needs of patients”, highlighting that payment by results had acted as a “barrier”.

The report also said Monitor and the NHS Commissioning Board “must ensure policies on regulation and competition facilitate integrated care where it will bring benefit”.