Essentially this is a policy shift towards more joined-up working between the many different entities who are responsible for, or can influence, the overall health of local populations. In London there are currently high-level aims drafted, with the form required to deliver these to be decided locally, based on local needs. The main aim is that different organisations and teams communicate with each other and join up care, wherever they may be based.
Dr Lisa Harrod-Rothwell, our CEO, remarks: “As GPs, we are particularly aware of how the current fragmented and siloed system adversely impacts on patient satisfaction, outcome, costs efficiency, health inequities and our time and wellbeing as we try to navigate the system on our patients’ behalf.”
Your LMCs have been involved in providing a grassroots GP voice in this process at a borough, ICB and pan-London level, via individual LMCs, LMC Strategic Leadership Networks (who mirror ICB boundaries) and Londonwide LMCs.
This work includes:
- Helping to dispel misconceptions about general practice.
- Helping stakeholders to understand the full role of the GP and of practices embedded in local communities.
- Explaining the resource, workforce and demand challenges and system constraints that affect practices’ day-to-day working.
- Picking up questions and concerns from constituents and taking them to the system partners working on INTs for clarification and resolution.
Because much of the decision making is taking place at a local level it is not possible to cover each ICB’s approach nor the individual Place teams within them here. Also many decisions at all levels have yet to be made as the INT process goes through iterative stages. If you are interested in getting an update on what is happening in your area then please contact your LMC.
Why have INTs?
Moving to a more community-based, preventative model of care is a central part of the Government’s plans to resolve the mismatch between demand and capacity across the health and social care system. They believe that by better connecting different health, wider public sector and voluntary organisations there will be greater opportunities to make early interventions that keep people healthier and reduce pressures associated with more severe forms of ill-health.
Which organisations will be part of INTs?
The aim is to bring together primary, community, mental health and specialist services; children & young people’s and adults’ social services; public health, housing and wider public services; and voluntary, community and faith groups. Patients, their carers and their families will also be involved, either via the groups already listed or by giving individual feedback.
Who is overseeing the rollout of INTs?
The current proposal is that each Place will be responsible for nominating an ‘Integrator’ who will be an organisation from within the corresponding borough and this body will take on the hosting of the functions required to coordinate multidisciplinary working. The rollout of INTs has yet to get as far as deciding on who each of London’s 32 Integrators will be and national guidance is expected which may alter the process.
Modules of delivery
Current London plans envision 10 core modules of ongoing activity and an eleventh temporary one:
- Geography: defining our neighbourhoods.
- Workforce: developing our teams.
- Relationships and interfaces: enabling joint working.
- Participation: working with communities.
- Population Health Management: addressing inequalities.
- Information sharing: building our shared view.
- Access and technology: making interaction easier.
- Governance: working together safely and efficiently.
- Metrics: evidencing success.
- Resource allocation: powering the change.
- Managing the transition: from national to neighbourhood.