Benefits of health and social care integration

Since the inception of the NHS, an ever-present challenge has been to improve integration of care within the health care system and with social care.

Many people have complex and ongoing care needs and require support from multiple agencies and various professionals (Lehnert et al., 2011).

But care is often fragmented and uncoordinated, with no one agency taking overall responsibility, so it is often left to individuals and their families to negotiate the system as best they can.

Traditionally,in England, health and social care funds have been channelled to institutions not individuals. Institutionally based funding fails to recognise that many people, particularly those with combinations of conditions, move across institutions, receiving care in multiple settings. But this creates problems.
Patients find it difficult to negotiate their way through the health and care system.

Care providers have had little financial incentive and have lacked financial mechanisms to allow funding to follow patients as they move from one setting to another. It has been recognised that financial arrangements need to be revised so as to support rather than inhibit organisations to work collaboratively around the needs of patients(Department of Health, 2012).

South Somerset’s Symphony Project is designed to establish greater collaboration between primary, community, mental health, acute and social care, particularly for people with complex conditions.

The Project is based on the principle of collaborative care, centred around the needs of individual patients. This means that all of the different organisations involved in delivering services will need to work together to deliver a tailored package of care. Collaborative working is to be incentivised by a shared outcomes framework. There will be joint responsibility for all organisations to deliver the
outcomes, and with linked financial structures under an ‘alliance contract’.
To support this ambition it is necessary to understand what drives health and social care costs. This will enable stratification into groups in order to inform the appropriate targeting of the programme toward those patient groups which are the highest users of services, who can be identified both by activity and cost (Kadam et al., 2013).

Budgetary arrangements can then be developed for these targeted groups.

To support these ends, health and social care data have been collated from multiple sources for the entire population within the South Somerset GP Federation. The Federation covers 17 practices around Yeovil District Hospital NHS Foundation Trust. In this report we analyse these data in order to identify those groups of people for which collaborative care might be most beneficial.