The Royal College of Physicians welcomes the opportunity to respond to the consultation on contracting arrangements for integrated care providers. The RCP would like to emphasise that it is fully committed to a universal NHS, free at the point of delivery, and equal access to free healthcare for the whole population.
It is widely agreed that there is a need for greater integration of care to improve patient experience, quality of care and outcomes. It is hoped that integration will help address current unsustainable pressures within the NHS and social care, and, as the challenge of caring for an ageing population with multiple co-morbidities grows, represent an opportunity to collaborate and improve the patient journey.
Recommendations for integrated care
In order for there to be widespread change, there must be joint working between primary care, secondary care, mental health, social care and the voluntary sector. The RCP believes that in order for there to be real value, we must consider the health and wellbeing of the population, best care for the individual and sustainable financial environment. In order for there to be value, integrated care must be:
- safe – minimising the harm to staff and patients from the care that is intended to help them
- effective – based on scientific knowledge reliably delivered to all who choose to benefit from it
- person-centred – care that is respectful of and responsive to the needs and values of the individual patient, family and carers. Care should be coordinated and care decision should be made in partnership between professionals and patients/carers
- timely – reducing waits and harmful delays for those who both receive and give care
- equitable – care that does not vary in quality of delivery or outcome because of personal characteristics, geographic location, time of the day or week, and socio-economic status
- evidence based – using and sharing existing audit, quality improvement and best practice information
- innovative – continually seeking to challenge and improve care
- sustainable – to ensure models are appropriate for future generations.
The RCP welcomes the safeguards in place to ensure that local population priorities are met, that there is financial stability and a reduction in the complexity of payment mechanisms. It is vital to ensure that there is clinical leadership and patient engagement at every stage of the development and implementation, therefore further safeguards should be included to ensure that this is the case.
Specialty physicians are able to support the development of specific care pathways. Plans must also ensure that the context of workforce is fully considered to ensure suitable skills and safe levels of staffing to deliver high-quality care.
The Royal College of Physicians looks forward to engaging with this work further in due course.