The Care Quality Commission (CQC) has reviewed how well different health and care services work together to support the needs of older people in England.
In its report, Building Bridges, Breaking Barriers, it warns that despite a widespread commitment for integration across the sectors, substantial progress is needed to better support people who use a number of services, reduce hospital admissions and avoid confusion about where to go for help. The report concludes that with a growing elderly population, now is the time to act.
People in England are living longer with the number of people aged 65 and over in the UK projected to rise by 40% in the next 17 years to nearly 17 million. Older people typically have the most complex needs and consequently receive care from more than one service and often across multiple locations; for example from an acute trust, a community trust, a GP, and a home care provider.
As the population grows, the providers of health and social care need to find more efficient ways of delivering care and reducing costs, the report says. The Government and health and social care organisations have identified integrated care as a key step in responding to an increased number of people who have complex needs.
People with complex needs who use a range of services will often say they are satisfied with individual providers but when they move between different services, their care can become fragmented and have an adverse impact on their experience of using care, the report says. When staff from different services talk to each other and share information effectively, people experience better, safer care. When they do not, care can become disjointed.
To carry out this review, CQC inspectors gathered evidence from a range of sources, including speaking to older people and their carers to understand their experiences. They inspected services within eight areas across England to look for examples of effectively coordinated care and to identify barriers which prevent care from working well. The report concludes that substantial progress is needed to achieve the collective ambition that individuals receive joined up personalised care and support.
The British Geriatrics Society welcomed the report. Dr Eileen Burns, President-Elect of The British Geriatrics Society and Clinical Lead for Integration in Leeds, said: “The CQC’s report ‘Building Bridges, Breaking Barriers’ accurately shows that although there is widespread commitment among health and social care professionals to providing integrated care for older people, there is still a long way to go. Findings from the report indicate that barriers include a lack of common understanding about how to deliver integrated care, a lack of consistency and mainstream implementation, as well as services struggling to identify older people who are at risk of deterioration or unplanned hospital visits. This report correctly identifies the opportunity that the 5 Year Forward View Vanguards and Sustainability and Transformation Plans offer to plan for and embed a shared vision of the delivery of integrated care."
The British Geriatrics Society urges all health and social care leaders, commissioners and local health care providers to review the report and implement its recommendations. Integrated and person centred care must be at the heart of decision making about provision. Investment in social and care services is fundamental to improving patient outcomes in our increasingly ageing population, and key to ensuring the future sustainability of our National Health Service”