In November 2013 the Department of Health selected 14 ‘integrated care pioneer’ sites throughout England to test different approaches to delivering person-centred and co-ordinated care across local health and social care systems. One of these sites is North West London, where clinical commissioning groups and local authorities have embarked on a large-scale programme of ‘Whole Systems Integrated Care’.
The Nuffield Trust, in partnership with the Personal Social Services Research Unit at the London School of Economics and Political Science, undertook an evaluation of this programme during the first year of its development and early implementation. Findings were published in October 2015.
In many areas across England, health organisations and local authorities have been testing and implementing different approaches to integrated care as a way to improve the coordination of services for users and their families, and to secure financial efficiencies across health and social care. The Nuffield Trust has been involved in evaluating a number of these initiatives, including the National Evaluation of Integrated Care Pilots, a study of the implementation of the Inner North West London Integrated Care Pilot, and numerous other community-based health and social care interventions.
In North West London, clinical commissioning groups and local authorities have joined with health, social care and other partners to form an alliance that is driving a large-scale programme of Whole Systems Integrated Care. This programme builds on pre-existing initiatives within North West London, including the Inner and Outer North West London Integrated Care Pilots, and the Tri-Borough Community Budget Pilot. In November 2013, it was designated by the Department of Health as one of 14 national integrated care pioneers.
The Whole Systems Integrated Care programme aims to improve the quality and experience of care for patients and service users, save money across the local health and social care system, and enhance professional experience by helping people in health and social care work more effectively together.
To meet these objectives, a range of integrated care schemes have been developed by health and social care organisations throughout North West London, each tailored to selected populations and local circumstances.
Some of these schemes have become ‘early adopters’ and will be piloting new services and sharing their lessons more widely before the approach is planned to be rolled out across North West London in 2015.
The Nuffield Trust and London School of Economics and Political Science were commissioned to undertake a 15-month evaluation (February 2014-May 2015) of the Whole Systems Integrated Care programme. The study was funded by Imperial College Health Partners and the North West London Collaboration of Clinical Commissioning Groups.
Using primarily qualitative methods, we are examining the processes by which the integrated care programme is being designed, how local stakeholders have been involved and whether the programme is on track to achieve its objectives. We are also studying the development and progress made by a sample of early adopter schemes, focusing on barriers and enablers to making changes to local services.
The evaluation drew conclusions about the effectiveness of the process of developing new forms of integrated care across North West London and the early progress made by early adopter services. Our analysis also considered how the North West London experience compares with other community-based health and social care interventions of this nature, both in the UK and overseas.
We published the findings and recommendations of our evaluation in a research report, Putting integrated care into practice: the North West London experience, in October 2015.
For an for an indepth look at this evaluation, please download the full research findings.
As part of this evaluation, the Nuffield Trust also conducted two surveys.
The WSIC programme established nine local initiatives (‘Early Adopters’) to pilot and implement the programme at the local level. We surveyed the Early Adopter steering committee members between 13 November and 17 December 2014. The survey explored members’ perceptions of their early adopter’s progress, the usefulness of the WSIC Integrated Care Toolkit and its design process, as well as different groups’ involvement in the project. A total of 109 steering committee members responded to the survey giving an overall response rate of 60 per cent.
This survey was aimed at GPs in North West London – including those who were not directly involved in the WSIC programme. It was designed primarily to gather views on integrated care and what needs to happen locally to achieve change, for example by exploring GPs’ perceptions of their relationships with other sectors. Respondents were also asked about awareness of the WSIC programme.
The survey was fielded between 24 March 2015 and 8 May 2015, with one GP in each practice being asked to complete it. A total of 160 responses were received, giving a response rate of 39 per cent (assuming that one person per practice completed it).