5 Key Principles to Aid Your Integrated Care Collaborations

Chief Strategy and Transformation Officer, Katherine Pitts of Integrated Care 24 (IC24) joined Tara Humphrey on the Business of Healthcare Podcast (episode #160) to talk about the role of integrated care, and the challenges and opportunities she sees as ICS systems come together. Listen to the interview with Katherine here.

Tara and Katherine have distilled their advice and insights into five fundamental principles to aid you in developing your ICS collaborations.

1. Create time to trust

The learnings from COVID have shown we can do things quicker, and some of those barriers and organisational walls are not as apparent anymore.

When we talk about what good collaboration looks like, from a provider perspective, this means having a system integration that allows us to work together in a known, fragmented manner. From a patient's perspective, good integrated care is seamless, no matter when they come into the healthcare service. As a patient, you are referred to a service without even realising it. It is seamless integration.

This requires:

• Trust

• Communication

• Allowing for mistakes

• Managing uncertainty

• Continuing to break down barriers and more of an emphasis on external relationships in the NHS

• Embracing technology

• Careful positioning of our collective offers and services

• Being fleet of foot so we don't miss out on opportunities to combine our efforts

Most importantly, this requires time. Time for us to get to know each other and understand our services and collective experiences. Trying to work with people you do not know or trust, without a real sense of urgency can make collaboration a non-starter.

2. The opportunity to change the narrative

As healthcare leaders, we have the opportunity to change the narrative to focus on outcomes, health improvement and how to respond to health inequalities by approaching challenges through wider collaboration.

It's about looking at:

• What can we do?

• What do our patients need?

• Who do we need around the table?

Primary care, secondary care, community care, the third sector, housing or education, to name a few, should all be in the mix.

It's complex, but to reiterate, the focus needs to be on what we can achieve together.

3. Communicate changes to every level of the organisation

Change almost always leads to a level of anxiety within teams about what might happen next. The Integrated Care Design Framework published by NHS England provides a very useful guide that paints a picture of what integrated care systems should be aiming for.

When documents like this are circulated, our role is to translate the contents to every level of our organisation as a leader.

Translating the news from an organisational perspective is key to minimising and addressing the anxiety change brings and communicating what it means for people's roles.

It also helps to build trust and collaboration internally.

The list below provides tried-and-true methods to aid your communication, but are you fully utilising these methods?

• Webinars

• WhatsApp

• Newsletters

• Leadership meetings

• Team meetings

• Q and A sessions

• Walkabouts

4. When comms go wrong

Communication across multiple organisations is vital, and more importantly, we need to appreciate the impact of when our communications go wrong.

Our tone, timing, spelling mistakes, inaccuracies, a lack of acknowledgement or staying silent on an important matter can break trust immediately. Add in social media and WhatsApp groups, your bad news will spread like fire, so we need to take this very seriously and make sure:

1. Are all parties on the same page?

2. Has all information been fact-checked?

3. Are our communications transparent?

4. Do we have a comms strategy?

5. Have we tested critical communications with critical friends?

6. Do we have a plan in place if things go wrong? (Sometimes, we will need to act quickly or act strategically when things go wrong)

Alongside this, leaders need to ensure that the culture and behaviour match the values, vision, and ICS organisational strategy.

5. Dive deep into the communities you serve

Quality starts with your people, and our colleagues must understand their impact, no matter how big or small the part they play in integrated care.

It is important to have a strategy developed around quality improvement that identifies who the ICS should be serving and not the people it perceives it should be serving. To create this, an understanding of the system and the challenges that our population experiences is required.

We know Covid-19 has magnified some health inequalities. From loneliness to people contracting services. And when thinking about our language, we need to be mindful of labelling patients that are hard to reach. Are they hard to reach, or are they easy to ignore?

• Pool your data to help inform the gaps in your patient care

• Speak to your commissioners and ensure all information presented is fully understood by you

• Speak to those on the front line; what are they seeing and experiencing?

• Speak to your patients; what are they saying?

We need to dive into the communities that we work with to understand their needs.

If you found this blog useful, check out:

• Principles for good governance

• How to Carry Out a Communications Audit

Integrated Care 24 provide a range of services including NHS 111, out of hours, and primary care for health and justice in prison care environments. IC24 also offers a range of primary care services in urgent care including, home visiting face-to-face care, telephone triage and clinical assessment service.

IC24 has been around since 1990. It was formed from a number of GP co-ops and has transformed into a larger organisation that has evolved over the years. Katherine Pitts has been with IC24 for several years and has recently been promoted to Chief Strategy and Transformation Officer.

"My career has followed innovation within the NHS. I was a qualified nurse and worked for services where it was done differently. This experience is useful for the world we are entering. I was lucky enough to be part of the NHS Direct team before the Strategic Health Authority went live. Following that innovation, I feel committed and proud to work for the NHS, providing NHS services."

Hear more from Katherine in episode #160 on the Business of Healthcare Podcast.

Tara Humphrey is the founder of THC Primary Care, a leading healthcare consultancy supporting Primary Care Networks.

Tara and her team also work with GP federations supporting the implementation of clinical services and provide PCN Management training.

Tara has over 20 years of project management and business development experience across the private and public sector and has an MBA in Leadership and Management in Healthcare, is published in the London Journal of Primary Care, is the author of over 200 blogs and is the host of the Business of Healthcare Podcast.