Viewpoint: GPs at the heart of health and social care integration

Dr Lisa Bostock, from the Social Care Institute for Excellence (SCIE), writes about the work that professionals are doing to generate health and social care integration

Dr Lisa Bostock: 'It’s crucial to see more joint and integrated working between the NHS and social care.'
Dr Lisa Bostock: 'It’s crucial to see more joint and integrated working between the NHS and social care.'

Let’s meet two GPs.

Dr Joe Hall, and the Bromley-by-Bow Centre and GP Partnership, feature prominently in a new social care TV film from SCIE. They work in a deprived area of the East End of London but they’re keen to support local people to improve their health and wellbeing and achieve their full potential. The partnership has a joint reception and GPs can refer to all the services available in the centre. Dr Hall says that the average person who turns up wanting help doesn’t differentiate between health and social care provision, and nor should they. In the past, when patients arrived at their door, they would have been sent to either health or social care services; Dr Hall would have only been able to say: ‘Sorry, but I’m just a clinician.’ But now, with the joint offering, they are very proud of the service they provide. Dr Hall says: ‘People can have many social issues that are blocking them from moving forward with their health.’

Our second GP is seen eating sandwiches in Norfolk. But it’s an important working lunch; once a week, Dr Simon Hibberd is joined by other professionals, including a social worker from the local authority adult team, as they discuss the needs of patients, many of whom would have, in the past, been referred on to hospital. In 2003-2004 the North Elmham Surgery was one of the practices in Norfolk referring the highest number of people to hospital. Surgery staff discovered that this wasn’t always because of medical issues; it was mainly because of the social issues that frail, vulnerable and older people were facing in their own homes. So this multi-agency group meets up to discuss concerns and support strategies. Dr Hibberd says: ‘The patient, who in the past, would have been seen possibly by all these people separately, now has the benefit of all of these professionals now speaking to each other. They get a better standard of care.’ His surgery is now one of the lowest referring practices in Norfolk.

Building key relationships

The Health and Social Care Act 2012 now gives clinical commissioning groups (CCGs) responsibility for local health service commissioning. As the groups begin taking stock, centres like those in London and Norfolk are building key relationships and agreeing their priorities. It helps if professionals from different agencies have effective relationships, so that integration can happen. In Dr Hall’s case, they have it in the bricks and mortar of the building.

So, our film shows two surgeries where there is now a much wider service. With rising numbers of people living with long-term conditions, it’s crucial to see more joint and integrated working between the NHS and social care. Professionals all want to achieve good outcomes and make the best use of resources. Clinical commissioners can redesign services to ensure that patients and their families get the care that will improve their health outcomes, and that will be more efficient and effective.

We have another film on integration; it looks at health and wellbeing boards, and how they strengthen the role of local government in planning and delivering local health services. To do this they must be strategic. Dr Andrew Coward, GP representative for south and central Birmingham, is seen describing how this approach has opened his mind to the importance of working together to tackle public health issues such as obesity.

Barriers to information sharing remain

We’ve also got a new handy ‘at a glance’ publication on health and social care integration, for those GPs who would like an introduction to get them started. In it, we look at what promotes, and what hinders, joint working. We also explore implications for people who use services, along with carers, practitioners, organisations and researchers. We report that some professional and cultural barriers to information sharing remain. Professionals can benefit from feeling confident in the processes for sharing information and understanding how this benefits people who use services.

We hope that our new resources will be helpful to GPs as they deal with new legislation, and if they need support in new ways of integrating health and social care provision.

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