Health January 29, 2019
Unlocking the power of integration

By News Feature - Accountable Care Journal

We often ignore the power of people and place, the shared unifying factors that determine our lives, when designing public services, whether they are NHS, Council, police, job centres, colleges, housing or any publicly funded body, writes Donna Hall, Wigan Council and Wigan CCG Chief Executive, Lead Greater Manchester CE for Public Service Reform and Chair New Local Government Network.

In Greater Manchester, we are turning the traditional model of public service on its head through our new Greater Manchester Reform Model. Each of the ten councils involved have created integrated place-based teams in populations of 30,000 - 50,000 people.

This radical new model brings together health visitors, community groups, police, mental health workers, fire prevention, doctors, pharmacists, schools, veterans support, drug and alcohol, housing, hospital discharge teams, elected councillors, adults and children’s social workers.

They are a team working together for all of the people in that place. They have daily huddle meetings to discuss a plan of action to help support each family and each person and to provide customised community support, friendship and neighbourhood networks. We are seeing amazing results already. Impressive outcomes and reducing costs.

In Wigan, as part of The Wigan Deal, we have seen costs reduce dramatically by working differently and not wasting time and money on passing people around a fractured and incoherent system. We have a key worker allocated to each family or individual and strong links through our 'community book' encyclopaedia of community activity and groups to what’s the best support we can possibly provide. We now have balanced social care budgets and have avoided 2,000 ambulance visits to A&E in two months.

Public servants love this different way of working. Hospitals are no longer hermetically sealed buildings where they could exist anywhere. They are part of the community they serve and they need the rich local intelligence to be able to meet the needs of all the people they serve. Social workers can work to help the whole family not just protect the child. We find levels of staff satisfaction in the place-based teams is amongst the highest of any one of our separate organisations.

It is so simple and uncomplicated so why don’t we all just do it?

It’s sometimes easier to set up a new governance structure, to spend years arguing over who hosts a new integrated care organisation, to blame austerity for repeated service failure and to write endless academic think pieces than to sit down with people in places and work with them to support them to be the best they can be.

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