As with other areas of health and social care, there is a growing interest in integrating care by bringing together family doctors, geriatricians, community nurses, occupational therapists, physiotherapists, speech therapists, dieticians, pharmacists, social workers and mental health workers. Over time this approach should mature to offer seamless services, with common IT systems that allow data sharing, common care pathways and accountable managers with single budgets coordinating multidisciplinary teams, leading to greater efficiency and better outcomes.
Baroness Sally Greengross, Commissioner, Equality and Human Rights Commission, UK
Caring for the elderly in hospitals is a huge – and in many cases, unnecessary – cost. As health systems are increasingly held to account for value and health outcomes (rather than volume), an integrated model can improve the quality and range of treatment within residential and nursing homes, which should reduce lengths of hospital stay and admissions.1
Elderly institutions require high-quality support from geriatricians, specialist nurses and other highly trained clinicians, while the care home staff will also need training to improve their skills in areas such as intravenous fluids, syringe pumps and pain management. Technology can play a big role, to enable specialists to remotely offer advice and review medications.
However, integration also carries some risks, not least by making patients overly dependent upon a single care provider. Such concerns can be mitigated to some extent by requiring integrated providers to offer choice and through carefully monitoring patient satisfaction and other performance measurements.
Gabrielle Davits, Chief Executive Officer, Foundation for Regional Healthcare (SVRZ), the Netherlands
1Choices, Policy Logics and Problems in the Design of Long-term Care Systems, Social Policy & Administration, December 2002.