Integrated Care For All: Promoting Health and Wellbeing Through Diversity
Integrated Care for all: Promoting Health and Wellbeing Through Diversity
Evidence to inform the development and strengthening of integrated care has grown considerably over the past two decades through primary research, people’s lived experience of accessing health and care, and the practice knowledge of professionals and practitioners. We now have a much better understanding of the impacts of interventions such as care co-ordination, multi-disciplinary teams, shared pathways and peer support. We also have better insights into how to implement across a system through policy incentives, organisational budgeting, individual record systems, and adapting professional cultures.
However, our knowledge of how to fully embrace and respond to diversity within integrated care contexts and opportunities has been limited. Population diversity is increasing worldwide through migration, cultural exchange, employment patterns, and demographic changes. Recognising and embracing this diversity through building on the new networks, communities and collaborative opportunities it presents, will be vital for integrated care to be relevant and inclusive in the longer term. Engaging with diversity is relevant across people’s life span, for those who face complex social issues, in times of transition, and in relation to mental and physical wellbeing. Co-producing services with those who reflect current diversity will be key to ensuring that they are built around what matters to people and their communities.
Widening the diversity of the workforce engaged within integrated care is also key to strengthening its impact. The vital role of health and care professionals in achieving more person-centred and coordinated care has long been recognised including doctors, nurses, social workers, therapists and others. There is though much less known about to better integrate the contribution of those who often have most contact with people and their families, such as those working in direct care roles, housing support, and peer support. As Integrated care looking to address wider health and care inequalities, programmes also look to improve the health and wellbeing of populations alongside improving individual care. This requires the engagement of a wider workforce, including those based within the voluntary and community sector, broader public services including transport, education and criminal justice, and the business community.
Finally, we need to continue to enhance interventions and approaches to embed and support integrated care through ensuring there is sufficient diversity to reflect changing needs and contexts. New technologies present both challenges and opportunities to our existing models as they change how people communicate and interact with each other and with services and can lead to greater inequalities in access. Integration must be open to forge new partnerships with emerging sectors whilst retaining its core values and principles and continuing to people at the centre. In recent years, integrated care has increasingly engaged within building on social, environmental and cultural assets within our communities and neighbourhoods. There is though much more to learn about how integrated care can collaborate with such community strengths and resources.
1. Improved Outcomes through Community-Based Care
A longstanding aspiration of integrated care has been to provide holistic and pro-active care for people in their communities which reduces the need for people to receive treatment in hospitals and moving into long-term institutional care. Robust community-based support is also vital to facilitate successful discharged from hospital settings when treatment is completed and to enable them to regain their independence and quality of life. There are through many challenges to changing the balance of health and care systems so that there is greater investment in community-based options whilst also ensuring there is easy access to specialist treatment and support. This theme will explore new innovations in primary and community-based care, how these can be configured around neighbourhood and communities, collaboration with the voluntary and community sector, and new models of shared care across community and specialist settings.
2. Enhanced Value-Based on Prevention and Technology
Preventative care seeks to support people to maintain their well-being through providing support and education on good physical and mental health, self-management of underlying conditions, reducing risks within people’s environment, and encouraging social connections and peer support. Technology has long been used to provide aids and adaptions which can practically help people to manage their day-to-day care and to enable to remain in their environment of choice. Wearable devices and new digital tools can now inform people on changes to their physical and mental state and support remote monitoring by multi-disciplinary teams. AI is developing the potential to anticipate potential health and wellbeing issues in advance of developing into more serious condition. This theme will explore how such technologies and other preventive approaches can be integrated into health and care practice, be made available to the populations who could benefit and be a facilitator of better collaboration between professionals and practitioners.
3. Reduced Inequalities with Social & Economic Development
Major inequalities continue within and between countries due to socio-economic uncertainties, shifting demographics, climate change, and discrimination related to disability, ethnicity, gender and sexuality. Those in society who are most marginalised due to serious health issue and /or complex social situations face inter-sectional barriers which result in limited access to treatment and support for populations who can be in the greatest need. Inequalities affect people’s wellbeing, life expectancy and their experience of accessing services. If not recognised and positively addressed such barriers result in less effective outcomes from integrated care resources and investments. This requires a good understanding of the populations likely to be affected and tailoring of individual support to reflect such inequalities. On a population level, this can require structural changes in how health and care systems are organised and governed to address bias in underpinning policy, legislation and funding. This theme will explore how integrated care can make a positive contribution to addressing inequalities through inclusive practices, collaboration with wider agencies, advocating for structural change, and investing in diverse workforce. The theme will also consider the potential role of social investment and economic development within integrated care.
4. Strengthened Workforce by Growing Capacity, Skills & Inclusivity
People’s experience of integrated care is largely determined by their interaction with health and care professionals and practitioners with a motivated, supported and skilled workforce being central to implementing new practice. There is greater understanding now of the competences and values which support collaboration and how these can be fostered through inter-professional education during qualification and beyond. This includes an important role for people with experience of health and care in professional and practice training and on-going development. Inclusive leadership is vital at practice, management and senior level, and through citizen leaders who represent geographic and other communities. There are through increasing challenges globally on recruiting and retaining key members of the workforce and in maintain the necessary overall capacity of the health and care system to deliver person-centred and continuous care. The skills required by the workforce is changing in response to digital innovations, community-based approaches, and new forms of practice. This theme will consider how integrated care can strengthen health and care workforce capacity through deploying inclusive workforce strategies, build new solutions through attracting diverse skills and insights, create innovative and impactful pre- and post- qualifying education, and support those with lived experience of health and care to develop their skills and knowledge.