Integrating Health and Social Care Services

Abstract

Background A recent UK Government draft Heath White Paper follows the NHS England long term plan when it states that NHS England requires “a new framework that builds on changes already being made as well as building in the flexibility to support the system to tackle challenges of the future”. At present the structure of Health and Social Care Services UK reporting to Government seems unhelpfully complex and opaque. Objective The purpose of this paper is to contribute to the building of a new framework using a generic approach to identify and use ‘systemic processes’ to facilitate the integration of Health and Social Care services in NHS England and elsewhere. Methods We highlight some of the critical issues that are currently hindering integration and set out a new way of understanding the structure of NHS England through an ‘inside-out’ analysis of systemic processes. Results We describe and give three examples of existing systemic processes as ‘Consulting a patient’, ‘Enhancing a Single point of access’ - to mental health services and ‘Delivering health and social care services England’. Conclusions Rethinking the interactions between existing organisations could arguably bring considerable benefits including cost savings, better co-ordination, less ‘admin’ stress on staff where the work is done and provide more organisational adaptability in an uncertain future. Ultimately our suggestions are aimed at helping people to deliver better patient care - the impelling purpose of all health and social care services.

The Healthcare and Societal Costs of Familial Intellectual Disability

“…This is in addition to the disability support pension and carer payment and carer allowance, which are welfare payments. Other countries, such as New Zealand, have offered more generous welfare payments for family carers, with the average rate being equivalent to the average rate of formal carers providing care and support services to a person with a disability or the elderly in New Zealand [ 37 ], and the UK has moved to integrate health and social care [ 38 ]. In Scandinavian countries, children with disabilities are provided with support to assist with their learning, with many municipal schools having established ‘resource schools’ since 2022 for the enrolment of children with certain disabilities, including physical, neuro-psychiatric, and ID [ 39 ].…”

“…In these families, the occurrence of ID, a neurocognitive disorder characterized by significant limitations in cognitive and adaptive functioning appearing and diagnosed before a person is aged 18 years old, is presumed to be caused by the same etiological factors [1]. The severity of familial ID is classified according to the intelligence quotient (IQ) of the affected person, as follows: mild (IQ 50-69), moderate (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and profound (<20) [2]. The global prevalence of ID is approximately 1%, with an estimated 20-50% of all ID cases of being of genetic etiology, and 450 identified genes are known to cause ID [3].…”

Availability and stability of palliative care for family members of terminally ill patients in an integrated model of health and social care

“…Higher sum scores indicate heavier psychological burden from patients and diseases. HAMA score was divided into no anxiety (≤ 7), possible anxiety (7)(8)(9)(10)(11)(12)(13)(14), definitely anxiety (14-21), obvious anxiety (21)(22)(23)(24)(25)(26)(27)(28)(29), and severe anxiety levels (≥ 29) [40,41]. Additionally, in DT, a cut-off value of ≥ 5 is considered clinically relevant distress with a need of professional psychological support [42,43].…”

“…The integrated model of health and social care delivery encompasses a coordinated approach to providing comprehensive services to individuals with complex needs. It integrates various aspects of health care, personal care, and supportive services to address the needs of vulnerable populations, particularly the elderly and those with limited self-care abilities, with the goal of improving and maintaining their health status and quality of life [8][9][10][11][12]. Since its inception, this model has aimed to bridge the gap between fragmented care systems and ensure seamless delivery of services across different care settings.…”