Helping bring integrated care teams to life: Bill’s story

Jane Holmes on delivering seamless care through integrated care teams

Senior advanced nurse practitioner Jane Holmes on delivering seamless care through integrated care teams

Integrated care teams (ICTs) aim to deliver seamless, joined-up care around the needs of an individual, but they bring changes in the way healthcare is delivered that the public may not understand.

The multidisciplinary team (MDT) working to introduce this model of care in the Midlands Partnership NHS Foundation Trust – an integrated provider of adult social care, community physical healthcare, mental health and learning disabilities services – decided to inform patients how this new model would work for them by devising an animation to explain it.

As a senior advanced nurse practitioner at the trust, I have been working with the programme to support the development of ICT pilot sites. Developing the model of care has fundamentally changed the way I view a person’s needs. In my 15 years’ experience as a nurse I have provided complete episodes of care and recovery to my patients. But, I have always focused on my area of expertise, which is healthcare.

Working in an ICT changes this. Being part of an MDT enables me to spend my time with colleagues from a myriad of backgrounds – primary care, community healthcare, mental health, social care and the voluntary sector. Together we aim to provide better care through a holistic approach that pulls on the variety of the MDT’s skills and competencies. It is invaluable information at your fingertips which is enhancing care delivery and ultimately resulting in better outcomes for the people we care for.

We wanted to share the concept of ICTs in a way that gave people the opportunity to understand the future direction of primary and community care in their local community

Bill's story

In the summer of 2018 we started to work on a short animation which tells the story of Bill. He’s a 68 year old man with a series of health and care needs. But his needs were exacerbated by the death of his wife, which forced him to live alone. Through the support of a local ICT, Bill regained his independence and his overall health and well-being improved.

Our brief was to make the concept of an ICT easy to understand and accessible to everyone who needed to know – this included patients and staff.

The team chose the format of an animation because it allowed us to strike the right tone and develop a story which was general enough for it to resonate, while enabling us to demonstrate the positive impact of colleagues working beyond traditional organisational boundaries.

My colleagues in the MDT and I used our own experiences to create a set of health conditions and care needs for Bill. We wanted to keep Bill’s needs simple because we are all aware of how complex health and care systems can be to navigate, something which often has a negative impact on a patient’s experience and is a driver for the creation of ICTs. We wanted Bill’s story to be a resource which everyone can access, understand and take assurance from.

The animation demonstrates why ICTs have been designed and how they will benefit our local communities. Through Bill we can showcase how ICTs are aiming to streamline healthcare systems and reduce duplication, meaning patients won’t have to tell their story numerous times. ICTs enable us to provide more accessible care and support that is specific to the individualised needs of our patients. 

Although the animation is primarily targeted at the general public – the people who will receive care and benefit from ICTs – it can also be used as a resource for staff including, but not exclusive to, those who work in primary care, physical care, mental health care, social care and the voluntary sector.

To ensure the animation was going to be suitable for all of these groups we undertook a series of engagement exercises with Together We’re Better partners, patients and members of the public.

Since Bill’s integrated care story launched we have received excellent feedback from staff who now feel able to visualise what local ICTs can do to support the local communities they work with. But, most importantly, members of the public have told us that they have traditionally found the NHS and other local authority systems hard to understand but Bill’s story isn’t. After watching the video they want to see this way of working in action.

About the author

Jane Holmes is a senior advanced nurse practitioner, Midlands Partnership NHS Foundation Trust

This article is for subscribers only