Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 27 Uncomfortable Truth 12: We have been trying to integrate health and social care for decades. The Nuffield Trust Ian: Social care providers are very interested in better integration of services. We have never made it happen for a variety of reasons. There is a lack of data from care providers as it has never been captured in the past, and we only started doing this in the pandemic. We haven’t got a mechanism for different parts of the system to communicate with providers, and we are locked out of resources and secure ways to communicate, so we want to see something more generic and more effective. We also need to know which services are available and where, and when to refer, to ensure the system works in a more integrated way. We would not make inappropriate referrals and we would get the right response. In one recent example where we didn’t get a mental health response, we ended up in the Emergency Department for 36 hours. Richard: There is much room for improvement in integration, understanding what we mean by the term, and why we are doing it. People tell us they want to live better, more fulfilled lives, and that they want to get support in a way that’s accessible to them and makes sense to them. If we are going to really tackle inequalities, we need to do more joining up of how we operate. But it still feels after so many years that our systems and processes are too complex, even for us to navigate let alone any of our communities. “We are still too often guilty of designing our services around ourselves, not necessarily thinking about the end service user.”