Ponencia a cargo del director de politicas y colaboraciones del National Voices en el National Health Service inglés, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.

1. Integrated care… or person
centred care?
Don Redding
Director of Policy, National Voices
@MightyDredd
www.nationalvoices.org.uk

2. About National Voices
1. National Voices is a coalition of NGOs in England that stands
for people being in control of their health and care.
2. We want person-centred care: people having as much control
and influence as possible over decisions that affect their own
health and care.
3. We work mainly at national policy level in England; but are
increasingly supporting local change.
4. We have 160 members who are national health and care
charities. Many of these members work with people who have
long term conditions.

3. England’s many plans for integration
‘Vanguards’ begin to replace pioneers: prototyping
new care models
‘Integrated care’ is a strategic priority for national
government; NHS given new legal duties
Single definition adopted; 25 ‘pioneers’ funded to
innovate using different approaches
NHS Long Term Plan for 10 years: integration in all
areas via ‘primary care networks’
2012
2013
2015
2019

4. Person centred coordinated care
“I can plan my care with people who
work together to understand me and my
carer(s), allow me control,
and bring together services
to achieve the outcomes important to me.”
Information
My
goals/outcomes
Communication Decision making
Care planning
Transitions
The single definition: ‘narrative’ 2013
4
From ‘Integrated Care:
Our Shared
Commitment’,
Department of Health,
England 2013
https://www.gov.uk/go
vernment/publications
/integrated-care

5. What matters to service users?
My goals & outcomes
“I am supported to understand my choices and to set and achieve my goals.”
“Taken together, my care and support help me live the life I want to the best of my ability.”
Care planning
“I work with my team to agree a care and support plan.”
“My care plan is clearly entered on my record.”
Care coordination
“I always know who is coordinating my care.”
“I have one first point of contact. They understand both me and my condition(s). I can go to them
with questions at any time.”

6. Progress 2013-2018?
• Too much focus on organisations & structures:
“poor communication and a confusing acronym
spaghetti of changing titles and terminology,
poorly understood even by those working within
the system”
• Need for a new or revived ‘narrative’:
“central to all the plans to create new structures,
partnerships and contracts [must be] that these are
a means to achieve more coordinated, person-
centred and holistic care for patients, particularly
patients with long-term conditions.”

7. NHS Long Term Plan 2019-29
‘New Service Model’
• Historic shift to primary & community care -- £, contracts, activity
• Primary Care Networks to cover England
• Reduce Emergency Department usage, & cut outpatients by a third
• ‘Digital first’ access
• Population health management in integrated regional systems

8. Primary care network
General
Practices
Community
health
Social
Care
Mental
Health
Voluntary and
community sector
Join together small practices to serve 30-50,000
Adopt population health management
Expand workforce (new roles)
Clinical leadership of the network
Integration at local level
Regional Integrated
Care System
X 5/6/7

9. ‘Universal, personalised care’
Part of ‘new service model’
A single, coherent set of interventions: the
Comprehensive Model of Personalisation
All local areas; 2.5m people by 2024
Primary care networks to deliver
www.england.nhs.uk/personalisedcare/upc/

10. Comprehensive Model for Personalised Care
All age, whole population approach
People with long
term physical
and mental health
conditions
30%
People
with
complex
needs
5%
Supporting people to
stay well, Building
community resilience,
Enabling people to
make informed
decisions and choices
Supporting people to
build knowledge, skills
and confidence and to
live
well with their health
conditions.
Empowering people,
integrating care and
reducing unplanned
service use.
Whole population
100%
TARGET POPULATIONS OUTCOMES
• Proactive case finding
• Care planning
• Support to self manage
• Increase patient activation
• Health coaching, peer
support & self
management education
• Personal budgets
INTERVENTIONS

11. In clear language!

12. Primary care network
General
Practices
Community
health
Social
Care
Mental
Health
Voluntary and
community sector
Join together small practices to serve 30-50,000
Adopt population health management
Expand workforce (new roles)
Clinical leadership of the network
Integration at local level
Regional Integrated
Care System
X 5/6/7

13. New personal journey
Primary care network
Community
health
Social
Care
Mental
Health
Pharmacist
Nurses
Physiotherapist
Access to
specialists?
Support for self management
health coaching; prevention; self management education; peer
support; exercise; wellness; recovery; befriending; arts.
Link
Worker
Community
support groups &
organisations
Paramedic
Care &
support
planning:
my goals
Secondary care
Care
coordination
General
Practice
Shared decisions

14. Get in touch
Don.redding@nationalvoices.org.uk
+44 20 3176 0738
www.nationalvoices.org.uk
@MightyDredd