Integrated Care Networks

Why is it that the NHS sees each episode of care as unrelated.   The term “discharge letter”  seems to imply that the hospital is not expecting to see this person again.  A much better term would be a  “summary of care” letter, it suggests that care continues and the hospital is explaining its role to other professionals in the process of care.

The language that professionals use to explain what they are doing tells us what their intentions are.  People expect their care to be integrated, they want the next person to know that the last person they saw had diagnosed and the treatment plan embarked upon..  Sadly it seems that in the UK what we expect and what we get are very different.

The DOH is looking at a number of integrated care pilots involving social services, housing and local government.   My concern is that the NHS needs to integrate the care it provides between primary and secondary care long before it looks to involve others.

My principles for integrated care start with those defined by the WHO, they are:

        • universal access to care and coverage on the basis of need;
        • commitment to health equity as part of development oriented to social justice;
        • community participation in defining and implementing health agendas;
        • intersectoral approaches to health.

and I would add:

        • treatment, care and support to be person-centred, inclusive and holistic to address the wide ranging needs of the person

        • the service response to be needs-led and not limited by organisational or administrative practices

        • collaborative working between agencies and service providers at each stage in the progress of the individual in treatment, care and support, through to rehabilitation and reintegration into the community

The NHS should make sure its current provision maps to these principles.

Looking forward to 2009

image John Coulthard, director of healthcare at Microsoft UK, reflects on the challenges facing the health service in the year ahead. He argues the coming year will be dominated by the need to make extremely demanding efficiency savings, while delivering on the personalisation agenda set out by Lord Darzi.


The main theme of the coming year will be the recession, and for everybody involved in healthcare the challenge will be how to do more with less. The years of plenty are over, but delivery of the huge policy agenda set out by Lord Ara Darzi at the end of his Next Stage Review has only just begun.

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