Surveys on integrated care
The BTS Models of Care Committee recently commissioned two surveys to find more out about integrated care in the UK.
The first was a scoping survey to try and unearth what services are already out there, what they do, which patients groups they serve and which HCPs are involved:
The purpose of the second survey was to try and find out more about respiratory trainees’ experience of, and attitudes towards, integrated care:
Both surveys were illuminating, and the committee had an interesting discussion about the preliminary results at the May 2017 BTS Models of Care Committee meeting. Alice Joy, BTS Lay Trustee, attended the meeting and has since provided a response to the surveys, particularly the trainees’ survey.
Here, Alice shares her thoughts on the two surveys and the wider role of integrated care:
The British Thoracic Society carried out two surveys on integrated care; one for members of the organisation and one for trainees. For patients, the word “trainee” may suggest an individual who has limited knowledge and experience of being a doctor. In fact, the trainees included in the survey were doctors of several years’ experience, who had worked in different medical specialties and who had chosen respiratory medicine as their area of specialism. These are people who have a keen interest in patients with breathing problems and in the care that their patients receive.
“Integrated Care” is a term much in use these days, but what does it mean?
I have talked to many patients about what the term means to them, and it boils down to this. Patients want health care in which all the professionals involved in their care – hospital doctors, GPs, nurses, therapists, technicians, social workers, mental health professionals, dieticians – talk to each other, agree and abide by standards of care, develop and practice models of care that put the patient at the centre and communicate effectively with patients and their carers. They want systems that ensure that they are not left suspended in uncertainty about what will happen to them or what they should do. They want to be seen as people and not as clusters of abnormal or dysfunctional cells.
For clinicians, integrated care is about joining primary care (GPs, nurses and community services) with secondary and tertiary care (hospital clinicians) to provide a more rounded, more effective and efficient service to patients and their carers. These aspirations are very similar so, in practical terms, clinicians and patients want the same things.
The trainee survey sought to find out whether training in integrated care had been offered to, and taken up by, these doctors. It also invited them to comment and some of the comments were very revealing.
More than a quarter of respondents were at a very advanced stage in their training and yet the results showed that most of these people had received little or no training in integrated care. More positively, most (90%) of respondents felt that more training would be beneficial. This needs to be addressed by those who plan, construct and deliver training.
Some comments, such as “It’ll only create more box ticking on portfolios which doesn’t translate into improved clinical practice” and “If I wanted to work with GPs […] I would’ve trained as a GP!” indicate that not everyone was sold on the idea.
What about patients? Are they sold on the idea? Do they agree with the principles of integrated care? Perhaps a survey of patients would tell us! However, my suspicion is that many patients would be unfamiliar with both the term and its application to health care. Therefore they, like doctors, could do with some training. Those who have come across it would, I think, heartily endorse it. So, doctors, take note of patients’ needs. Listen to their stories and try to understand how complex a world health care is for them and how important it is that you and your colleagues work in harmony with one another and with your patients to deliver the kind of care in which we all play a part and for which we all take a responsibility.