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Integrated care

Fundamental to HealthOne NSW is the integration of general practice and community health services (and other health and community care services as required locally) in a way that is different from either a conventional general practice or community health service.
 
Integration can be expected to:
  • improve a person's experience of the health system
  • improve individual and population health outcomes
  • reduce the fragmentation resulting from two levels of government funding different parts of the system
  • create efficiencies through sharing resources and services
  • introduce more robust governance arrangements for the health and wellbeing of populations (and use of resources)
  • more professionally satisfying work environments for health professionals
 
While integration is a frequently used term, there are different views on what it means, both theoretically and practically.
 
In practical terms, for HealthOne NSW it means that the planning, administration and provision of primary health care will be integrated. However, the HealthOne NSW model anticipates the transition from autonomous services to integrated services will take time. Service partners may agree on a staged approach, starting with collaborative or coordinated arrangements.
 
The strength of the partnership between Area Health Services, general practice and any other organisation involved in the development of a HealthOne NSW service (for example Divisions of General Practice, local government) is critical. The Partnership Assessment Tool (link) provides an opportunity to test readiness for entering into arrangements, or to assess how well a partnership is progressing against agreed targets and standards.
 
Integration cannot be achieved without some careful thinking about the vision, values and motives of partner organisations, the financial and administrative arrangements and the workforce to be involved.
 
For a simple and elegant overview of some practical aspects of integration, A Practical Guide to Integrated Working (link) is recommended. This guide has been developed to assist the National Health Service and local government in the United Kingdom to develop integrated health and social (ie community) care services. For a more theoretical overview, the reference list may be helpful.

References of interest

Boon, H., Verhoef, M., O'Hara, D. & Findlay, B. (2004). From parallel practice to integrative health care: a conceptual framework. BMC Health Services Research, 4(15).

Burgess, T. & Beilby, J. (2003). Integrated primary health care and community care in South Australia. Final report. University of Adelaide, Department of General Practice. Link to article

Care Services Improvement Partnership (2008), Bringing the NHS and Local Government together: A practical guide to integrated working.

Davidson, P. (2006). Beyond the rhetoric: what do we mean by a 'model of care'. Journal of Advanced Nursing, 23(3), 47-55.

Grone, O. & Garcia-Barbero, M. (2001). Integrated care: a position paper of the WHO European Office for Integrated Health Care Services. International Journal of Integrated Care, 1(1), 1-10. Link to article

Kodner, D.L. & Spreeuwenberg, C. (2002). Integrated care: meaning, logic, applications and implications - a discussion paper. International Journal of Integrated Care, 2: 1-6. Link to article

Leutz, W.N. (1999). Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. The Milbank Quarterly, 77(1): 77-110.

Partnership Assessment Tool (2006) Leeds: Nuffield Institute for Health.

This web page is managed and authorised by Inter-Government & Funding Strategies of the NSW Department of Health. Last updated: 4 March, 2009

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