Daily Insight: Integration pioneers put to the test | Daily overview

A handful of “pioneer integration” areas need to test “radical new approaches” to accelerate discharge from acute hospitals.

Local NHS and council managers have been asked to submit bids by June 30 for ‘new service models, such as providing a more integrated model of interim care within existing health and social care “, and “the design and testing of new enabling provisions, which could include new funding models, more integrated workforce models or the deployment of new technologies”.

The letter from ministers and NHS England said speeding up discharge from hospital was ‘just’ a potential benefit of the integration and indicated that ‘future phases’ of the pioneers could be focused elsewhere.

Delayed furloughs have put a major strain on the system over the past year, particularly last winter, and the letter states: ‘Delayed furloughs are a very visible signal that the health and care system remains fragmented and too often fails to provide integrated services. that meet people’s needs.

It comes as more and more NHS organizations have explored direct provision or provision of social care, including the Northumbria Healthcare Foundation Trust which announced in January it was setting up direct provision, to solve exit problems.

Debut in data turns out to be a revelation

New data suggest that there is huge geographic variations in the number of referrals for a “two-hour rush response” recorded.

New interim data from NHS England shows the performance of community emergency response services against a key NHS long-term plan target of reaching at least 70% of patients referred to them within two hours of by December 2022.

The performance data – the first published for community health services – also includes the number of referrals reported as “in range” of the target and the total number of service contacts. There are huge variations in both, regardless of the size of the area or the needs.

In terms of referrals, for example, Bristol, North Somerset and South Gloucestershire, Gloucestershire and Lincolnshire ICS all reported only five such referrals each, while most systems reported at least 100. Most referrals were reported by Kent and Medway and Norfolk and Waveney Health and Care Partnership ICSs, which in April each reported more than 1,200 such referrals.

There was also wide variation in the number of care contacts associated with two-hour crisis response services. Bristol, North Somerset and South Gloucestershire; and Lincolnshire; ICS reported five and 10 of these contacts respectively, while all other systems reported at least more than 100, and most reported more than 1,000. ICS North West London reported 6 820 DUC care contacts in April – the most of any ICS.

The aim of Community Emergency Response Services, which was a key commitment in the 2019 NHS Long Term Plan, is to provide care to people in their homes, avoiding unnecessary hospitalizations.