Integrated care pilot drives up dementia diagnosis

The first year of a large-scale integrated care pilot resulted in a marked increase in dementia diagnoses and the frequency of diabetes testing.

Dr Judith Smith: evaluated impact of integration
Dr Judith Smith: evaluated impact of integration

The North West London Integrated Care Pilot is a clinically led programme to develop new care planning and coordination models, based on an IT tool, for people with diabetes and the over-75s.

A Nuffield Trust and Imperial College London evaluation of the first year of the project found 'considerable progress in formalising engagement between organisations'.

Researchers said healthcare professionals were found to have a high level of commitment to the integrated care pilot, but over half of them reported an increased workload. And many practitioners reported dissatisfaction with the IT tool, with concerns over duplication of data entry, problems with interoperability, and functionality.

Other findings from the evaluation include:

  • 64 % of patients who had a care plan reported improved access to NHS services.

  • 55% had to spend less time booking appointments to see their GP.

  • 67% reported that healthcare staff asked fewer questions about their medical history.

  • 81% of patients reported they felt involved in the development of their care plan.

  • 88% that they had a clear understanding of how care planning works.

  • 13% of patients said they had a copy of the care plan that was created with their GP.

  • 60% had not experienced any changes to the provision of their care.

The evaluation found no change in the rate of hospital admissions.

Director of policy at the Nuffield Trust Dr Judith Smith said: ‘Our evaluation described the early impact of the integrated care pilot to help its development beyond the first year and to inform other integrated care initiatives in the UK and overseas.

‘The benchmarks set in this first evaluation report provide a sound basis for the pilot to assess its progress against, particularly in relation to activity, cost, and health outcomes. International evidence points to the fact that integrated care takes years to develop, and a minimum of three to five years is needed for such initiatives to show impact in relation to activity, patient experience and outcomes.'

Imperial College London’s e-Health unit director Dr Josip Car added: ‘The evaluation reveals the achievements and challenges that would be familiar to those who have attempted to bring about large-scale transformational change in the NHS in the past. There were some changes in the process of care recorded on GP information systems. For example, there was a marked increase in diagnoses of dementia after August 2011, when the pilot started and in the frequency of testing for diabetes.'

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