Integrated feedback for an integrating world

In the past week everyone has been sharing their thoughts on the new plan for the NHS in England, so I thought I’d join in.

I’m going to focus on just one of the many policy topics in this rather long and jumbled document: “integration”. This is one of the elements of the plan which is both clear and forceful.

The plan states:

“The NHS and our partners will be moving to create Integrated Care Systems everywhere by April 2021, building on the progress already made. ICSs bring together local organisations in a pragmatic and practical way to deliver the ‘triple integration’ of primary and specialist care, physical and mental health services, and health with social care.”

And, while the plan in general sees little role for citizens being actively involved in shaping and improving their public services, this is an area where people are given some (limited) part to play:

“A new ICS accountability and performance framework will… provide a consistent and comparable set of performance measures. It will include a new ‘integration index’ developed jointly with patients groups and the voluntary sector which will measure from patient's, carer’s and the public’s point of view, the extent to which the local health service and its partners are genuinely providing joined up, personalised and anticipatory care.”

I have argued before that, if you want to know whether some set of services is, or is not, “integrated”, you’ll absolutely need to hear from those using them. So this is certainly a step forward.

But equally, I think there is a substantial risk that the “integration index” idea could easily also become a step back. Like the widely disliked “NHS Friends and Family Test”, it creates the risk of premature quantification: that measuring something (anything!) creates a spurious objectivity, encourages an industry of methodologists and implementers, places focus on the score alone, encourages gaming to pass the test, and distracts us entirely from the point.

The point being: what are people’s actual experiences of care across multiple organisations? What is working well or badly, and how can things practically be improved?

Care Opinion is perfectly suited as a feedback tool for the emerging care landscape

Because Care Opinion enables people to share stories which relate to multiple services, feedback can go beyond the "single organisation" focus of FFT, revealing how services do or don't join up.

For example:

• An experience of inpatient mental health care and a forensic outreach service
• An experience of general practice and hospital urology care
• An experience of emergency and orthopaedic hospital care, and intensive home support
• An experience of stroke care and (lack of) neuro-rehab care

Care Opinion is the only feedback system which enables this kind of feedback based on experiences spanning multiple providers (including social care and primary care). The platform is flexible, powerful and mature, and perfectly suited as a feedback tool for the emerging care landscape of the next few years.

The move towards “integration” in England will be difficult and subject to all kinds of resistances. In that context, focusing on the real experiences of patients and the practical issues they raise is a powerful way to help people work together with the shared purpose of improving what we have now.

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Download information on how Care Opinion fits with ICSs