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‘A team without walls’ – the RCP’s future hospital vision in action

‘A team without walls’ is the integrated respiratory team’s (IRT) vision at King’s Health Partners - the latest case study to join the Royal College of Physicians’ (RCP) future hospital movement's Tell us your story initiative.

The IRT at King’s Health Partners’ vision of ‘teams without walls’ is bringing specialist care to patients, rather than the other way around. The service it provides ensures that local patients living with a long-term lung condition, and their carers, experience high-value, collaborative and coordinated care wherever they need it.

The team is supporting patients to recover more quickly and closer to home, after admissions to hospital. Every member of the team is trained in collaborative care planning to support patients to meet the goals that are important to them. The service has seen a reduction in the cost of medications prescribed, resulting in an estimated financial saving of £200,000 in 12 months for just one clinical commissioning group (CCG) which has been reinvested in high-value treatments.

The IRT aims to ensure that respiratory patients receive the right care in the right place first time. For example, a GP who is concerned about a housebound patient with COPD can arrange a planned joint review with the IRT consultant or specialist team in the patient's home. These joint consultations support accurate diagnosis and agreed priorities of care for patients with complex breathlessness in the community. This can avoid multiple hospital appointments or ensure that subsequent visits to hospital by the patient are as planned and focused as possible.

The IRT is co-led by an integrated respiratory consultant and two GPs, working with other clinicians across the hospital and community, including specialist nursing, physiotherapy, pharmacy, smoking cessation services and mental health teams. The support and long-term commitment from the local CCGs have also been critical to the development of the IRT.

The Future Hospital Programme aims to develop and implement the RCP vision for the future of medical care in hospital and community settings. Through its Tell us your story initiative it is building examples of good practice through a network of healthcare professionals dedicated to providing an integrated, person-centred health system that crosses the boundaries between primary, community and hospital based care. The network will also allow professionals to connect to share experience and learning and access a variety of resources that support the future hospital.

Dr Irem Patel, the respiratory consultant who leads the service, said:

After reading the Future Hospital Commission report we realised that the work we were currently undertaking fitted with many of the aims of the programme. When the Tell us your story initiative launched, we saw it as a great opportunity to tell others about the work we are doing whilst also gaining new ideas from others. Ultimately, if we are to meet the needs of patients with long-term conditions, we need to change the way we think and the systems we work in.

Dr Anita Donley, clinical vice president and chair of the Future Hospital Programme said:

The RCP is dedicated through its Tell us your story initiative to capturing examples of innovative practice that are aligned to the Future Hospital principles. The work at King’s is a prime example of this and highlights the RCP’s vision for how hospital services can adapt to meet the needs of patients now and in the future.

The RCP calls on NHS physicians and other healthcare professionals to share more stories of person-centred best practice.

To share your story, please visit our Tell us your story webpage or contact futurehospital@rcplondon.ac.uk


For further information and to arrange an interview with the Future Hospital Programme, please contact Joanna Morgan, Care Quality Improvement Department communications manager on +44 (0)20 3075 1354 or email Joanna.Morgan@rcplondon.ac.uk

Notes to editors

  • Dr Irem Patel is an integrated respiratory physician working in SE London, and is COPD, asthma, oxygen and smoke free lead for Kings College Hospital NHS Trust.
  • The Future Hospital Commission was established by the RCP in March 2012. The commission’s recommendations were published in Future hospital: Caring for medical patients in September 2013.