Developed over 16 local areas, this guide captures common features of good practice of integration between health, social care and the voluntary and community sector. The guide looks at leading integration and the key services and approaches that are needed for effective integration. These include commissioning, risk stratification, information sharing, and multi-disciplinary team working. Practical service examples under three themes show where integration can have a specific impact. The themes cover: Promoting self-care and independence; Supporting care closer to home; and Care and support in a crisis. The guide is aimed at directors, service managers and operational staff in both health and social care. Case studies and links guidance and resources are also included.
(Edited publisher abstract)
Developed over 16 local areas, this guide captures common features of good practice of integration between health, social care and the voluntary and community sector. The guide looks at leading integration and the key services and approaches that are needed for effective integration. These include commissioning, risk stratification, information sharing, and multi-disciplinary team working. Practical service examples under three themes show where integration can have a specific impact. The themes cover: Promoting self-care and independence; Supporting care closer to home; and Care and support in a crisis. The guide is aimed at directors, service managers and operational staff in both health and social care. Case studies and links guidance and resources are also included.
(Edited publisher abstract)
Subject terms:
integrated care, case studies, good practice, leadership, prevention, local authorities;
This guidance supports integrated care boards (ICBs) and their partner NHS trusts and foundation trusts with system partners. The National Health Service Act 2006 (as amended by the Health and Care Act 2022) requires ICBs and their partner trusts to prepare their JFP before the start of each financial year. This guidance sets out a flexible framework for JFPs to build on existing system and place strategies and plans, in line with the principle of subsidiarity. It also states specific statutory requirements that plans must meet. It should be read alongside guidance on NHS priorities and operational planning which can be found here. Specific JFP supporting resources will be available here. Systems have significant flexibility to determine their JFP's scope as well as how it is developed and structured. Legal responsibility for developing the JFP lies with the ICB and its partner trusts. However, we encourage systems to use the JFP to develop a shared delivery plan for the integrated care strategy (developed by the ICP) and the JLHWS (developed by local authorities and their partner ICBs, which may be through HWBs) that is supported by the whole system, including local authorities and voluntary, community and social enterprise partners.
(Edited publisher abstract)
This guidance supports integrated care boards (ICBs) and their partner NHS trusts and foundation trusts with system partners. The National Health Service Act 2006 (as amended by the Health and Care Act 2022) requires ICBs and their partner trusts to prepare their JFP before the start of each financial year. This guidance sets out a flexible framework for JFPs to build on existing system and place strategies and plans, in line with the principle of subsidiarity. It also states specific statutory requirements that plans must meet. It should be read alongside guidance on NHS priorities and operational planning which can be found here. Specific JFP supporting resources will be available here. Systems have significant flexibility to determine their JFP's scope as well as how it is developed and structured. Legal responsibility for developing the JFP lies with the ICB and its partner trusts. However, we encourage systems to use the JFP to develop a shared delivery plan for the integrated care strategy (developed by the ICP) and the JLHWS (developed by local authorities and their partner ICBs, which may be through HWBs) that is supported by the whole system, including local authorities and voluntary, community and social enterprise partners.
(Edited publisher abstract)
Subject terms:
health care, integrated care, planning, joint working;
Review and clinical codes for unpaid carers. An unpaid carer is anyone including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid. When we refer to carers in this document, this is inclusive of both adult and young carers (under 18). The law is very clear about who is an unpaid carer. There is a need to improve the identification, recognition and support of unpaid carers as part of proactive prevention approaches being pursued at a population health level. Where carer registers are coded and linked to patient records, this has not been done consistently. There are >80 existing SNOMED CT codes which relate to unpaid carers, or which could be perceived to relate to unpaid carers. As such, primary care data for unpaid carers isn't consistent. This guidance sets out a recommended cluster of SNOMED CT codes for unpaid carers, of all ages, to enable and demonstrate the delivery of the NHS Long Term Plan and People at the Heart of Care. Consistency when coding unpaid carers will help to ensure that carers are better identified and supported across and within systems. As a minimum, systems are expected to be able to report how many unpaid carers are registered in primary care, including the number of young carers, and of those unpaid carers, how many have a carer contingency plan recorded in records so that professionals can action them when required.
(Edited publisher abstract)
Review and clinical codes for unpaid carers. An unpaid carer is anyone including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid. When we refer to carers in this document, this is inclusive of both adult and young carers (under 18). The law is very clear about who is an unpaid carer. There is a need to improve the identification, recognition and support of unpaid carers as part of proactive prevention approaches being pursued at a population health level. Where carer registers are coded and linked to patient records, this has not been done consistently. There are >80 existing SNOMED CT codes which relate to unpaid carers, or which could be perceived to relate to unpaid carers. As such, primary care data for unpaid carers isn't consistent. This guidance sets out a recommended cluster of SNOMED CT codes for unpaid carers, of all ages, to enable and demonstrate the delivery of the NHS Long Term Plan and People at the Heart of Care. Consistency when coding unpaid carers will help to ensure that carers are better identified and supported across and within systems. As a minimum, systems are expected to be able to report how many unpaid carers are registered in primary care, including the number of young carers, and of those unpaid carers, how many have a carer contingency plan recorded in records so that professionals can action them when required.
(Edited publisher abstract)
Subject terms:
carers, health care, data collection, information sharing, record keeping;
Guidance on how to deliver quality public health functions in integrated care boards (ICBs). The checklist is provided by the NHS National Public Health team to support ICBs in providing a quality public health function across the ICS. It is endorsed by NHSEngland, the Association of Directors of Public Health, the Local Government Association and the Faculty of Public Health and draws
(Edited publisher abstract)
Guidance on how to deliver quality public health functions in integrated care boards (ICBs). The checklist is provided by the NHS National Public Health team to support ICBs in providing a quality public health function across the ICS. It is endorsed by NHSEngland, the Association of Directors of Public Health, the Local Government Association and the Faculty of Public Health and draws on national and international guidance on what a high-quality public health function looks like. Top tips include: know the local population; adopt an 'all hazards' approach to resilience and ensure the ICB plays its role in protecting the population; take account of relevant public health laws, regulations and governance structures; understand the role of partners across the ICS in supporting effective and efficient health systems, multi-sectoral planning and financing of population health; advance public health research; promote the prevention and detection of non-communicable and communicable diseases; consider the NHS’s contribution to the wider determinants of health; support community engagement and social mobilisation for health and wellbeing; support and integrate the public health workforce; ensure equitable access to high quality health care.
(Edited publisher abstract)
Subject terms:
integrated care, public health, population, health, health inequalities;
A framework to support children and young people with mental health in the instances where attendance or admission to an acute setting may be the most clinically appropriate option. Over the past decade, there has been increasing need for mental health services to support children and young people. The pandemic resulted in a greater number of children and young people presenting with mental health disorders, often with complex needs requiring care or medical stabilisation, within a paediatric or acute setting. This framework commits to ensuring children and young people, and those who look after them, are supported. The framework consists of six elements: 1. Ensure that five key principles underpin joint working to support CYP with mental health needs who present in acute paediatric settings, and that a culture is fostered where we work collaboratively in providing holistic care for our CYP; 2. Develop ways of working that bring system partners together across the patient journey and understand where systems are in developing joined-up pathways. This may include learning from areas doing good work to transform care across their wider footprint; 3. Understand system maturity by considering 'what good looks like' and where the system sits along that journey; 4. Ensure that specific consideration is given to managing CYP with a learning disability or autistic CYP who may present to hospital with acute mental health needs - some systems have developed a holistic approach; 5. Work together to ensure the clinical team(s) within the acute setting have the support they need to deliver high quality care - this includes ensuring access to training and education across the system; 6. Testing and developing the evidence around innovative practice.
(Edited publisher abstract)
A framework to support children and young people with mental health in the instances where attendance or admission to an acute setting may be the most clinically appropriate option. Over the past decade, there has been increasing need for mental health services to support children and young people. The pandemic resulted in a greater number of children and young people presenting with mental health disorders, often with complex needs requiring care or medical stabilisation, within a paediatric or acute setting. This framework commits to ensuring children and young people, and those who look after them, are supported. The framework consists of six elements: 1. Ensure that five key principles underpin joint working to support CYP with mental health needs who present in acute paediatric settings, and that a culture is fostered where we work collaboratively in providing holistic care for our CYP; 2. Develop ways of working that bring system partners together across the patient journey and understand where systems are in developing joined-up pathways. This may include learning from areas doing good work to transform care across their wider footprint; 3. Understand system maturity by considering 'what good looks like' and where the system sits along that journey; 4. Ensure that specific consideration is given to managing CYP with a learning disability or autistic CYP who may present to hospital with acute mental health needs - some systems have developed a holistic approach; 5. Work together to ensure the clinical team(s) within the acute setting have the support they need to deliver high quality care - this includes ensuring access to training and education across the system; 6. Testing and developing the evidence around innovative practice.
(Edited publisher abstract)
Subject terms:
children, mental health services, acute psychiatric care, hospital admission, integrated care, autism, learning disabilities, innovation;
This framework sets out the direction of travel and national priorities which will inform the development of integrated health and justice services across England. It has been informed by the views and experiences of people with lived experience, partner organisations, providers and our own team. This framework sets out our ambitions to work with the 42 integrated care boards (ICBs) and integrated care partnerships (ICPs) across England, as well as with our justice and police partners to further develop integrated pathways of care between the community and custodial environments. It links with and complements youth and criminal justice strategies, including the Prisons Strategy white paper. The framework highlights the complex relationship between health influences on offending (the focus on offending is not inclusive of children in secure settings for welfare reasons) and reoffending behaviour, alongside wider social influences, such as poverty, housing, social exclusion and adverse childhood experiences (ACE). The framework comprises twelve commitments: commitment 1 - putting the patient voice at the centre of everything we do; commitment 2 - working in partnership to commission high quality care; commitment 3 - supporting people with neurodiversity and complex health needs; commitment 4 - providing evidence-based treatment as alternatives to custodial sentences; commitment 5 - improving the health and wellbeing of vulnerable children; commitment 6 - improving the health and wellbeing of people in custody; commitment 7 - ensuring good mental health for adults in custody; commitment 8 - reducing early and avoidable deaths; commitment 9 - connecting people leaving custody to health services on release; commitment 10 - improving the health of people detained in immigration removal centres; commitment 11 - improving quality through learning and technology; commitment 12 - ensuring an inclusive and representative workforce.
(Edited publisher abstract)
This framework sets out the direction of travel and national priorities which will inform the development of integrated health and justice services across England. It has been informed by the views and experiences of people with lived experience, partner organisations, providers and our own team. This framework sets out our ambitions to work with the 42 integrated care boards (ICBs) and integrated care partnerships (ICPs) across England, as well as with our justice and police partners to further develop integrated pathways of care between the community and custodial environments. It links with and complements youth and criminal justice strategies, including the Prisons Strategy white paper. The framework highlights the complex relationship between health influences on offending (the focus on offending is not inclusive of children in secure settings for welfare reasons) and reoffending behaviour, alongside wider social influences, such as poverty, housing, social exclusion and adverse childhood experiences (ACE). The framework comprises twelve commitments: commitment 1 - putting the patient voice at the centre of everything we do; commitment 2 - working in partnership to commission high quality care; commitment 3 - supporting people with neurodiversity and complex health needs; commitment 4 - providing evidence-based treatment as alternatives to custodial sentences; commitment 5 - improving the health and wellbeing of vulnerable children; commitment 6 - improving the health and wellbeing of people in custody; commitment 7 - ensuring good mental health for adults in custody; commitment 8 - reducing early and avoidable deaths; commitment 9 - connecting people leaving custody to health services on release; commitment 10 - improving the health of people detained in immigration removal centres; commitment 11 - improving quality through learning and technology; commitment 12 - ensuring an inclusive and representative workforce.
(Edited publisher abstract)
Subject terms:
integrated care, joint working, health inequalities, health care, criminal justice, offenders, prisoners, complex needs, vulnerable children;
This resource is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This resource is firmly rooted in the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence.
(Edited publisher abstract)
This resource is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This resource is firmly rooted in the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence.
(Edited publisher abstract)
Subject terms:
nurses, midwives, good practice, professional conduct, racial discrimination, black and minority ethnic people, health professionals, racism;
This document builds on the previous 'Improving experiences of care' document, providing an updated view of improving experience of care for those working in health and care systems and partnerships, including within NHS providers. It sets out a shared understanding of experience and what the best possible experience of care looks like. The document also outlines the key components for delivering the best possible experience of care in systems and providers. These are: co-production as default for improvement; using insight and feedback; and improving experience of care at the core priority work programmes.
(Edited publisher abstract)
This document builds on the previous 'Improving experiences of care' document, providing an updated view of improving experience of care for those working in health and care systems and partnerships, including within NHS providers. It sets out a shared understanding of experience and what the best possible experience of care looks like. The document also outlines the key components for delivering the best possible experience of care in systems and providers. These are: co-production as default for improvement; using insight and feedback; and improving experience of care at the core priority work programmes.
(Edited publisher abstract)
Subject terms:
user views, quality improvement, service development, co-production, integrated care;
This is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems. At the heart of this report is a new vision for integrating primary care, improving the access, experience and outcomes for our communities, which centres around three essential offers: streamlining access to care and advice for people who get ill but only use health services infrequently - providing them with much more choice about how they access care and ensuring care is always available in their community when they need it; providing more proactive, personalised care with support from a multidisciplinary team of professionals to people with more complex needs, including, but not limited to, those with multiple long-term conditions; helping people to stay well for longer as part of a more ambitious and joined-up approach to prevention. Shifting the focus onto developing integrated neighbourhood teams, places and systems gives offers an opportunity to build a new, more effective health and care service designed with communities to fit their needs.
(Edited publisher abstract)
This is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems. At the heart of this report is a new vision for integrating primary care, improving the access, experience and outcomes for our communities, which centres around three essential offers: streamlining access to care and advice for people who get ill but only use health services infrequently - providing them with much more choice about how they access care and ensuring care is always available in their community when they need it; providing more proactive, personalised care with support from a multidisciplinary team of professionals to people with more complex needs, including, but not limited to, those with multiple long-term conditions; helping people to stay well for longer as part of a more ambitious and joined-up approach to prevention. Shifting the focus onto developing integrated neighbourhood teams, places and systems gives offers an opportunity to build a new, more effective health and care service designed with communities to fit their needs.
(Edited publisher abstract)
Subject terms:
integrated care, primary care, general practitioners, prevention, neighbourhoods, place-based approach, care reform;
This framework supports nurses, midwives and care staff in ensuring our care remains at a high standard, as well as demonstrating their significant contribution to the long COVID response. It gives them the opportunity to embrace our collective leadership in supporting the people and communities they serve and showcase good practice as it emerges across England. As a complex multi-system condition with more than 200 symptoms, long COVID's impact can be wide ranging - affecting a person's physical, mental and psycho-social wellbeing. This underlines the importance of a holistic approach to care. Specifically, this framework supports health and care staff to deliver care of the highest quality and value by: providing support for the modelling and commissioning of national, regional, and local work programmes; signposting to specific evidence-based tools, theoretical frameworks and resources to enable professional leadership response and support day-to-day practice; supporting quality improvement approaches to enable effective and safe patient care; contributing to continuous professional development and revalidation.
(Edited publisher abstract)
This framework supports nurses, midwives and care staff in ensuring our care remains at a high standard, as well as demonstrating their significant contribution to the long COVID response. It gives them the opportunity to embrace our collective leadership in supporting the people and communities they serve and showcase good practice as it emerges across England. As a complex multi-system condition with more than 200 symptoms, long COVID's impact can be wide ranging - affecting a person's physical, mental and psycho-social wellbeing. This underlines the importance of a holistic approach to care. Specifically, this framework supports health and care staff to deliver care of the highest quality and value by: providing support for the modelling and commissioning of national, regional, and local work programmes; signposting to specific evidence-based tools, theoretical frameworks and resources to enable professional leadership response and support day-to-day practice; supporting quality improvement approaches to enable effective and safe patient care; contributing to continuous professional development and revalidation.
(Edited publisher abstract)
Subject terms:
Covid-19, health professionals, care workforce, service provision, multidisciplinary teams, holistic care, integrated care;