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Integration through Care Co-ordination

Integration through Care Co-ordination. Belinda Weir, Senior Consultant, The King’s Fund Lara Sonola, Senior Researcher, The King’s Fund. Aims of session. To hear some evidence about effective coordinated care for people with long-term conditions

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Integration through Care Co-ordination

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  1. Integration through Care Co-ordination Belinda Weir, Senior Consultant, The King’s Fund Lara Sonola, Senior Researcher, The King’s Fund

  2. Aims of session To hear some evidence about effective coordinated care for people with long-term conditions To explore the factors which support coordinated care and analyse our own services in relation to these factors To share experience and consider what, if anything, we will do differently as a result of this workshop

  3. Sam’s story http://www.kingsfund.org.uk/audio-video/what-key-effective-care-co-ordination

  4. Co-ordinated care for people with complex chronic conditions 2 year project funded by Aetna/Aetna Foundation in the US Aims: To understand the key components of effective care co-ordination, examine key barriers and facilitators and develop practical lessons for the application of the tools of care co-ordination • Methods: Five demonstrator sites chosen through a competitive process based on their ability to demonstrate positive impacts in one or more of the following: patient experience, better health outcomes, more cost-effective care • We examined how care co-ordination was organised and operated in practice at a patient level through interviews with teams, documentary and observational analysis. Sandwell, Birmingham Greenwich & Bexley Greenwich & Bexley Pembrokeshire Midhurst, Surrey South Devon & Torbay

  5. Sandwell Esteem Team http://www.kingsfund.org.uk/publications/esteem-team

  6. Key Lessons

  7. Integrated commissioning • Supportive policy • Effective targeting • Localisation • 1-3 key leaders • Commissioning support • Supportive team culture/ shared values Systemic • Holistic • Patient and carer focused • Flexible Personal Organisational Design features Clinical and service Functional • Multiple referrals, single point of entry • Named care co-ordinators • No defined care packages • High touch-low tech • Shared electronic patient records • Personal communication Community • Voluntary sector involvement • Community awareness

  8. Research into practice How can you use these design features to deliver more joined-up care in your own system? Are there any other features you would add? • LEADERSHIP

  9. Any Questions?

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