This paper aims to demonstrate the approach taken in Norfolk, UK, to engage patients and staff to develop and improve services by stimulating improvements in integrated working. The two year programme focused on making specific improvements that patients said they wanted to see by working with staff who volunteered to take part in the programme.
The “Integrating Care in Norfolk” pilot (ICN) was one of 16 national pilots. GPs from 32 practices worked with local community staff to redesign services to meet “patient pledges”. The impact of changes on patients, staff and services were evaluated locally using questionnaires and by analysing data combined in a performance dashboard. The ICN was subject to both national and local evaluations, which provided a basis for comparison.
The local evaluation showed that progress had been made towards meeting objectives, including patients and staff satisfaction and reducing unplanned admissions. GPs recorded improvements to joint working, and all staff concerned chose to continue the project beyond the pilot period.
The findings of the local evaluation contrasted with those of the national evaluation. The Norfolk study demonstrated the positive impact of integrating care on patients, staff and services. The national study concluded that there were minimal or negative impacts of integrating care, although the study amalgamated all 16 pilots, with very different clients, services and objectives.
The ICN was novel in the way that patients and staff were engaged. Patients were invited to set an agenda for change, and provided a mandate to staff from each organisation to redesign their services. This approach may provide a solution to sustainable integrated working. The ICN was evaluated locally as well as nationally as part of the DH ICP programme, enabling respective findings to be compared and validated.
Tucker, H. and Burgis, M. (2012), "Patients set the agenda on integrating community services in Norfolk", Journal of Integrated Care, Vol. 20 No. 4, pp. 231-240. https://doi.org/10.1108/14769011211255267Download as .RIS
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