In the run up to the second annual Respiratory Futures integrated care debate, which took place on Thurs 6th Dec 2018 and discussed “can integration reboot the nation’s lung health?”, Respiratory Futures conducted a short survey. This survey was with the aim of generating external debate about the benefits and weaknesses of integrated care in the NHS, the current state of play, and if appropriate, what measures are needed longer term to embed it further within the NHS and care system.
122 NHS health professionals and commissioners responded to the survey. Nearly 9 in 10 (89%) believe that national policy-makers need a more radical strategy to encouraging integrated care and reducing demand on NHS hospitals.
Furthermore nearly 9 in 10 (89%) said that far more effective working between NHS hospitals, NHS primary care and social care was the most important factor that will improve health outcomes for people with respiratory disease in the future.
Nearly all respondents (98%) saw clear benefits to integrated care. These benefits were seen as:
- enabling patients to be treated closer to, or in the home (95%)
- providing better treatment and care for patients (95%)
- increasing patients’ quality of life (92%)
- reducing demand on hospitals (80%)
However, two thirds (66%) of respondents believe integrated care has insufficient resources and funding to be implemented successfully.
The following factors were identified as key barriers to the NHS delivering integrated care more widely:
- historic divisions in the way the NHS is structured and funded (89%)
- insufficient training to create a ‘hyper agile’ NHS workforce to be able to work across hospital and community settings (68%)
- insufficient incentives for hospitals to create integrated job roles to help deliver integrated care (67%)
- current problems with recruitment and retention of NHS staff (62%)
- lack of sufficient investment in IT infrastructure and governance (66%)
- lack of sufficient diagnostic services in the community (52%)
Aside from the need to achieve more effective working across the NHS and social care, the next most cited factors to improve health outcomes for people with respiratory disease in the future were:
- ensuring the NHS respiratory workforce is adequately staffed (73%)
- greater investment in public health activity (59%)
- the delivery of a national plan to improve lung health (54%)
Commenting on the survey results, Dr Binita Kane, Consultant Chest Physician, at Manchester University Foundation Trust, said:
“We hope that the NHS Long Term Plan will provide a major step forward in promoting integrated care and improving respiratory health across the country.
Integrated care involves moving away from the current hospital-focused, often reactive system of care - towards prevention and continuous community support that allows people to be treated and managed at home or closer to home. This will require seamless pathways of care across the whole system rather than the current disjointed care between providers.
But the key challenge for the NHS is how to achieve this at scale. We need to share respiratory expertise across the NHS, increase public health awareness about lung disease and train & create networks of multi-skilled health professionals to support people earlier on - empowering them to achieve good health themselves. And investment in the right IT infrastructure and diagnostic capacity in the community is also pivotal to a national roll out.
We are encouraged by the steps that are being taken to improve lung health, but we need to do more to ensure integrated care is prioritised and accelerated.
It benefits both patients and the NHS and has the potential to radically improve the lung health of the nation - and the time to scale it is now.”