GPs located in village halls cited in integration wishlist

Lords report touts solutions to better patient outcomes

Four key obstacles—structures and organisation, contracts, data-sharing, and workforce - hinder the implementation of integration policies in the health service, according to a new House of Lords report.

Patients at the centre: integrating primary and community care states that patients are constantly being inconvenienced, endangered, or miss improved long-term health because they are not receiving joined-up care, in the right place, at the right time.

“Integration can help improve patient experience and offers a viable solution to many of the challenges facing the health service,” says the House of Lords Integration of Primary and Community Care Committee, which published the report.

Informed by evidence submitted by the DDA, the report makes the following recommendations:

Structures and organisation: Membership of ICSs should be widened, with better inspection for improved accountability
Contracts and funding: The existing GP contract and partnership model hinders co-location and could be changed to improve multi-disciplinary integration. GP practices should become a physical hub where primary and community clinicians, and other services, are co-located. A multi-disciplinary team based around a rural single-handed GP practice might make use of community assets, like a village hall
Data sharing: data interoperability issues (the ease with which different computer systems can communicate) and widespread IT inadequacies need correcting.
Workforce and training: Integration should be included in initial clinical training and clinicians introduced to the work of other services through job rotations.

The report cites rural integration projects such as OneDevon High Flow, which combines council services, ambulance services, mental health services, primary care and GP-based community services to target and support the 20 highest-intensity users of health services in north Devon.

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