Integrated Care

This course explores the care planning process, using the political and social context as a backdrop to inform decision-making. Using case scenarios, learners will work together in groups to formulate a personalised care plan that puts the patient at the heart of the planning.

Key topics include the importance of cultural, social, and religious values and beliefs, and the professional role to ensure the best outcomes for the patient using a partnership approach to care planning.

Who is it for?

Anyone who is involved in care planning processes in any area of care provision including primary, secondary, and community settings, local authorities, and voluntary and third sector organisations.

Learning outcomes:

• Understand the role of the Integrated Care System (ICS), The NHS Long Term Plan and other key documents in the provision of care
• Recognise the importance of cultural, social, and religious values and beliefs of patients, their families, and carers and the impact these have on individualised care planning
• Discover the concepts of ‘choice and control’ and how we enable these for our patients, their families, and carers
• Appreciate the importance of decision-making, advocacy, and good communication in care planning
• Successfully complete an individualised scenario-based care plan that considers political, social, cultural, and religious values and beliefs and that is built in partnership with the patient at the centre of the plan

Learning content:

This learning is delivered through large group discussion and facilitated scenario-based learning in small groups:

• Overview of The NHS Long Term Plan and other relevant national policies and how these affect the context of care delivery and the role of the ICS in the future of care delivery
• The role of the multi-disciplinary team and external agencies (social care/GPs/other organisations) in planning care
• Working with the end in mind – what are the long-term goals of the plan
• Control and choice – what do these mean and how are they advocated
• Working with cultural, social, and religious differences to facilitate personalised care plans
• Consent and the Mental Capacity Act
• Decision-making, advocacy, and communication

The aim of this course is to examine the development of a multi-disciplinary approach to care provision within the health and social care setting.

With the introduction of Integrated Care Systems (ICSs), the focus of care delivery is shifting. Working across organisational boundaries and with multiple agencies within and external to the NHS, developing a coordinated care approach to service delivery will become central to planning processes.

Who is it for?

Those who are developing new models of care within ICSs, include healthcare professionals, managers, workforce planners, and social care providers.

Learning outcomes:

• Understand the political context and policy drivers
• Recognise the concept of a multidisciplinary approach to care delivery in terms of:
• Local requirement of function and form
• Key factors for success
• Challenges, barriers, and blockers
• Examine patient experience, feedback, and advocacy in developing services
• Understand professional accountability and responsibility
• Discover the evaluation mechanisms of service delivery

Learning content:

• Defining multi-disciplinary approach and coordinated care
• Defining roles, responsibilities, outcomes and evaluation processes
• Developing shared goals and objectives
• Communication strategies, culture, collaboration, and shared decision-making
• Clinical governance and risk stratification
• Functions of the coordinated care model and key factors for success
• Identifying pathways of care and using patient experience to develop services
• Managing the challenges, i.e.,
• Misaligned performance indicators
• Financial incentives
• Mental Capacity Act and the role of advocacy
• Accountability and working at the top of license to practice
• Professional protectionism vs patient-centred collaboration