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Nurses central to success of integrated care, says health charity CEO

The head of The King’s Fund says of all the frontline health professionals needed to successfully integrate health and social care, nurses will play the biggest role
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Nurses should be at the heart of community-based teams if integrating health and social care is to be successful, the head of a major health think tank has said.

The Kings Fund chief executive Chris Ham was speaking at his organisations annual integrated care summit this week.

He told Nursing Standard: Nurses understand the populations where they work. They know the people who are most at risk from poor health.

Huge opportunity

It is fundamentally important to have nurses at the heart of community teams.

They are the largest part of the health workforce and the range of different tasks they can take on at all levels is vast.

Asked how nurses who had not yet experienced service integration should feel about the prospect, Professor Ham said it offered a huge opportunity.

Volume to value

They should welcome it,

Nurses should be at the heart of community-based teams if integrating health and social care is to be successful, the head of a major health think tank has said.

The King’s Fund chief executive Chris Ham was speaking at his organisation’s annual integrated care summit this week.

He told Nursing Standard: ‘Nurses understand the populations where they work. They know the people who are most at risk from poor health.

Huge opportunity

‘It is fundamentally important to have nurses at the heart of community teams.

‘They are the largest part of the health workforce and the range of different tasks they can take on at all levels is vast.’

Asked how nurses who had not yet experienced service integration should feel about the prospect, Professor Ham said it offered ‘a huge opportunity’.

Volume to value 

‘They should welcome it,’ he added. ‘Nurses want to deliver care which is more joined up and not fragmented.’

The King's Fund summit brought representatives from across the UK and USA to share best practice on a number of integration models.

Dartmouth Institute of Health Policy and Clinical Practice director Elliott Fisher outlined the accountable care organisation (ACO), which 250 providers use to transform from ‘volume to value’-based care.

The model sees GP surgeries, hospital trusts and other providers placed in charge of delivering healthcare for a clearly defined population using a pre-agreed budget.

Motivational interviewing 

The focus is on giving patients the right treatment as individuals, whereas in the past providers were attempting to treat as many patients as possible in the shortest time.

Dr Fisher also identified how an ACO in Iowa created new roles for nurses, including one who used a technique called motivational interviewing.

Use of the technique helped alleviate symptoms of clinical depression in an older patient by getting him to talk about activities he enjoyed. Using his response, staff helped the patient revisit his former career of public announcing.

Nuka model

The event also heard about a model of care in Alaska called the ‘nuka’ – a native word meaning ‘strong living structures’ – which was developed by Southcentral Foundation 30 years ago.

By locating GPs, nurses and a variety of other health professionals, including dieticians and behavioural therapists, together in one building, they had eliminated the need for referrals and dramatically reduced waiting times.

Kings Fund project director Ben Collins wrote a report on the system and explained: ‘Some of the specialist nurses did need to re-train, which they weren’t that happy about at first.

‘Ultimately they got to spend more time with the people who needed them and less on administration – which is something they definitely appreciated.’


Further information

List of speakers and presentations from Integrated Care Summit 2016

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