Conversations matter – moving towards integrated care

As a newcomer to health and NHS issues I was surprised how negative the conversations around integrated care can be – until people start talking about real stories of care.

It would be fair to classify me as a fresh pair of eyes when it comes to observing the reform pressures in the Health system. It’s not too long ago I shifted my professional focus from blue-chip management consulting to independent advisory services to support systematic improvement in the health system. As an independent consultant I’m working with LH Alliances, collaborating on design and development of integrated care commissioning and delivery models. The topic is intriguing and something I feel more and more passionate about.

On 4 February I attended the King’s Fund conference Moving towards integrated commissioning, how can we prepare for the future? A great opportunity to listen to conversations happening between commissioners on what integrated care means to them, their role and their ambitions to change.

The first sessions started with a real emphasis on the constraints and challenges in the health system, with some strong messages about culture as well. I felt slightly disillusioned and at the same time irritated by the negative tone of some of the speakers. Their talks really ignited frustration and blame towards ‘the system’ and its existing structures and bodies. It took a while before I was listening to stories about value-creation and care for people.

“I’m at King’s Fund #integratedcare conf. Looking forward to a shift in conversation today, to really focus on value and co-creation” – @enpartnerships

In my personal opinion, it seems there really is a need to change the discourse in conversations about how we organise care. Moving away from conversations focusing on blame and instead focus on sharing of ideas and experiences worth spreading. I found it refreshing when the introductory slides of a presentation did not start with a bullet point overview of what’s wrong with the NHS, but instead introduced a vision for transformation through collaboration.

It was only when the speakers focused more on personal and relationship investment that it felt there was room to address a way forward. The knowledge and experience sharing through the case studies encouraged a very positive view. Having a change management background, it really caught my attention that there was such a strong emphasis on the need for a shift of focus of leadership in the NHS. To refocus their accountability from individual organisational capability towards joined responsibility for whole-system outcomes.

Taking a step back from the organisational context, I would argue that we would all agree to the same principles regarding what well integrated care should feel like. We can all relate to what feedback we would want to hear from our loved ones about how they felt when being cared for. My take away is that we need to bring this shared understanding more at the forefront of any conversation about integrated care reform, to help remind each other of what really matters and to refocus on making that happen together.

Nadine t Zand (@enpartnerships)

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