Integrated Carehttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/4472023-10-23T15:35:59Z2023-10-23T15:35:59ZClosing the circle: a key collaborative opportunity for general practice and psychiatryThurston, Lindahttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/10022021-12-21T18:00:43Z2021-11-01T00:00:00ZClosing the circle: a key collaborative opportunity for general practice and psychiatry
Thurston, Linda
Two of the authors were general practitioners (GPs) in the 1980s, when there was
much interest in consultation, stimulated by the psychoanalyst Michael Balint.
Around one in five psychiatrists worked in consultation liaison in general practice at
that time, but in the 1990s this was stopped to increase the focus on psychosis.
However, the Royal College of Psychiatrists and Royal College of General
Practitioners have a strong history of collaboration, and many psychiatrists, nurses
and GPs trained together in the national Trailblazers programme, focusing on service
delivery in all areas of mental health. Recent proposals for mental health community
collaborative networks from the NHS provide an opportunity for psychiatrists to work
with GPs and a range of other professionals once more, for complex non-psychotic
illness that cannot be helped by Improving Access to Psychological Therapies
services. The circle is closing for GPs like us, who were working in the 1980s.
Open access
2021-11-01T00:00:00ZMeasuring the benefits of the integration of health and social care: qualitative interviews with professional stakeholders and patient representativesExternal author(s) onlyhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/5622020-07-28T18:00:11Z2020-06-01T00:00:00ZMeasuring the benefits of the integration of health and social care: qualitative interviews with professional stakeholders and patient representatives
External author(s) only
Integrated care has the potential to ease the increasing pressures faced by health and social care systems, however, challenges around measuring the benefits for providers, patients, and service users remain. This paper explores stakeholders’ views on the benefits of integrated care and approaches to measuring the integration of health and social care.
Methods
Twenty-five semi-structured qualitative interviews were conducted with professional stakeholders (n = 19) and patient representatives (n = 6). Interviews focused on the benefits of integrated care and how it should be evaluated. Data was analysed using framework analysis.
Results
Three overarching themes emerged from the data: (1) integrated care and its benefits, with stakeholders defining it primarily from the patient’s perspective; (2) potential measures for assessing the benefits of integration in terms of system effects, patient experiences, and patient outcomes; and (3) broader considerations around the assessment of integrated care, including the use of qualitative methods.
Conclusions
There was consensus among stakeholders that patient experiences and outcomes are the best measures of integration, and that the main measures currently used to assess integration do not directly assess patient benefits. Validated health status measures are readily available, however, a substantial shift in practices is required before their use becomes commonplace.
Open Access
2020-06-01T00:00:00ZMeasures for the integration of health and social care services for long-term health conditions: a systematic review of reviewsExternal author(s) onlyhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/4482020-05-04T17:00:13Z2020-04-01T00:00:00ZMeasures for the integration of health and social care services for long-term health conditions: a systematic review of reviews
External author(s) only
Background:As people are living longer with higher incidences of long-term health conditions, there is a move towards greater integration of care, including integration of health and social care services. Integrated care needs to be comprehensively and systematically evaluated if it is to be implemented widely. We performed a systematic review of reviews to identify measures which have been used to assess integrated care across health and social care services for people living with long-term health conditions.
Methods:Four electronic databases (PUBMED; MEDLINE; EMBASE; Cochrane library of systematic reviews) were searched in August 2018 for relevant reviews evaluating the integration of health and social care between 1998 and 2018. Articles were assessed according to apriori eligibility criteria. A data extraction form was utilised to collate the identified measures into five categories.
Results:Of the 18 articles included, system outcomes and process measures were most frequently identified (15 articles each). Patient or carer reported outcomes were identified in 13 articles while health outcomes were reported in 12 articles. Structural measures were reported in nine articles. Challenges to measuring integration included the identification of a wide range of potential impacts of integration, difficulties in comparing findings due to differences in study design and heterogeneity of types of outcomes, and a need for appropriate, robust measurement tools.
Conclusions: Our review revealed no shortage of measures for assessing the structures, processes and outcomes of integrated care. The very large number of available measures and infrequent use of any common set make comparisons between schemes more difficult. The promotion of core measurement sets and stakeholder consultation would advance measurement in this area.
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2020-04-01T00:00:00Z