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Acute trust input needed to integrate care


6 June 2013

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Healthcare leaders – both in primary and secondary care – have called for local government and acute trusts to be “part of the conversation” in designing integrated care.

Speaking at the NHS Confederation Annual Conference in Liverpool,  Dr Mark Newbold,  chief executive of the Heart of England foundation trust said if community care is updated, acute care must be too.

Healthcare leaders – both in primary and secondary care – have called for local government and acute trusts to be “part of the conversation” in designing integrated care.

Speaking at the NHS Confederation Annual Conference in Liverpool,  Dr Mark Newbold,  chief executive of the Heart of England foundation trust said if community care is updated, acute care must be too.

According to Dr Newbold, acute trusts should be an “essential part” of the debate over increasing community –based care.

He said: “We don’t just want to end up with a struggling hospital sector. If you don’t update your acute services at the same time as you update your community services it just ends up as a mish-mash.

“Acute services need to be transformed, and we need to be part of community service transformation.”

‘Hard work’

But the changes are not likely to be as simple as siting around a table, David Smith, chief accountable officer of Kingston CCG believes.

Smith said: “CCGs are still very new organisations, and we have a lot to do. This isn’t going to happen quickly, there are lots of barriers.

“There’s a clear role for health and wellbeing boards, and a lot of people are saying that their key purpose is to drive the integration agenda. A key challenge if they can do it. In some places it’s working well – in others not so well. But what this means is we need some sharing of power between councillors and GPs.

According to Dr Smith, many GPs initially supported the Health and Social Care Act because they assumed it would give them more control over the budget.

Dr Smith added: “In fact, they don’t have control over the commissioning budget. If we’re going to make this work GPs and local government have to work together.”

Yet in Dr Newbold’s local area – where there is only one foundation trust, one clinical commissioning group (CCG) and one local council, they have already established virtual wards.

In the virtual wards, some patients recently discharged from hospital are treated in their own homes by district nurses.

They remain under the nurses’ care for eight days, reducing the number of beds used in hospitals and increasing patient satisfaction and recover time.

Dr Newbold said: “This is a great way to get movement through the hospitals. The problem isn’t with people coming in, it’s with people going out.

“We need to offer alternatives to admissions, and appropriate services that people can be referred to.”

For up-to-the-minute information on the NHS Confederation Conference, visit the live blog on The Commissioning Review.

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