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We must be more imaginative in co-designing integrated health and care

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Nobody can have gone away from the health session at July’s LGA conference in any doubt about the significance that NHS England chief Simon Stevens places on integration; not just the integration of health and social care, but also of primary and specialist care and mental health and physical health.

The recent LGC & HSJ Integration Summit provided an opportunity for participants to work together on a number of live integration challenges, which they brought to the event. To do this work we created a virtual health and care system, bringing together people from health and local government, commissioners and providers, together with local politicians, users and representatives of national bodies.

Three themes from that temporary health and care system are relevant to people seeking to drive transformation in their real health and care systems at a local level.

First, the challenge posed by Andrew Webster, director of integration at the LGA. In an opening session, his challenge to participants was that they must aim for radical change or risk failure, and that they must do so with less money.

Second, in a stocktake session halfway through the event, I reflected that most of the groups had established some important shared principles or objectives, but had not got into the nitty-gritty of how to implement them.

This reflects the actual position in many places. I describe it as being like a chocolate cake recipe with no weights and measure, cooking times or oven temperature. To make an edible cake you have to be specific about all that. To have any impact, health and care strategies must be precise enough to have real traction with the full range of health and care providers at a local level.

Filling in that detail can be difficult. It is likely to generate a perception of winners and losers. But it is as important in delivering health and care integration as it is to winning the Great British Bake Off.

Third, I came away from the event convinced that one way of ensuring that leaders of health and care systems take that step is through meaningful engagement with people who use services and their carers.

This year a number of users and carers participated in the summit and it was transformed as a result. It was more grounded, more focused on the impact of change on people, and less able to skirt over difficult and challenging issues.

Having seen how a relatively limited user engagement can fundamentally change a two-day summit, I am convinced that a more imaginative approach to co-production and co-design is absolutely essential if we are to respond to Andrew Webster’s challenge.

Phil Swann, managing director, Shared Intelligence. He facilitated the LGC & HSJ Integration Summit





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