Integrated care partnerships

agendaNi summarises how the new health networks will operate.

Northern Ireland’s first 12 integrated care partnerships (formal networks of health and care professionals and those using their services) are to be established by the end of June. The full set of 17 ICPs are to be in place by next March.

Health and Social Care Board Chief Executive John Compton sees the success of the partnerships as “absolutely critical” in delivering the Transforming Your Care reforms. Speaking to agendaNi in February, he said: “If you really are serious about wanting to enable people to be cared for and treated at or close to home, then the professionals who work in the community are going to be central to that.”

Each ICP will have 12 members and will include GPs, other ‘community practitioners’ such as pharmacists and opticians, hospital specialists and representatives of the independent and voluntary sectors, patients and carers. The appointments process for the voluntary, patient and carer members is still being finalised.

This new form of co-ordination is meant to make sure that people will deal with fewer professionals. Decision-making should become quicker with the most appropriate treatment starting at an earlier stage. It is also designed to encourage new ideas and innovation on how to manage conditions.

The typical partnership will cover a population of 100,000 people and they will therefore not be as local as most of the current council areas. However, this is in keeping with the Review of Public Administration in health and the formation of the new councils from 2015.

At a neighbourhood level, health care will be delivered by multi-disciplinary teams. Normally, these would include two GPs, a specialist nurse, an occupational therapist, a physiotherapist, a dietician, a social worker and several support care workers.

ICPs will have a role in promoting health and well-being and ‘embedding’ prevention into services. Practically, this will include more screening and immunisation programmes in the community, providing more health advice through pharmacies, and allied health professionals being involved in secondary prevention (e.g. podiatrists helping older people to walk in way that prevents falls).

The independent sector would provide more intermediate care e.g. ‘step-down beds’ for short-term rehabilitation after a hospital stay or ‘step-up beds’ to help prevent a hospital admission. Short-term reablement support would help people to learn or relearn the skills necessary for independent living.

In social care, ICPs will clearly specify the care and interventions to be provided in nursing homes, including intravenous therapy and catheterisation. This would extend to the management of end-of-life care in nursing homes, to avoid the distress of transferring an older person to hospital as their life is ending.

The ICPs will take a particular interest in the so-called FREDS cases i.e. frailty in old age, respiratory disease, diabetes, stroke and end-of-life care. They will also undertake complex case reviews, which will be anonymised and for system learning purposes only.

Proposed ICP areas

• North Belfast

• South Belfast

• East Belfast

• West Belfast

• Antrim and Ballymena

• Ards

• Armagh and Dungannon

• Causeway

• Craigavon and Banbridge

• Down

• East Antrim

• Lisburn

• Mid Ulster

• Western Trust: Northern

• Western Trust: Southern

• Newry and Mourne

• North Down