Making integrated care a reality in Southwark and Lambeth

Southwark and Lambeth Integrated Care (SLIC) has had a positive impact on improving care for local people, and has built a strong foundation for further integrating health and social systems across the two boroughs, according to a new report.

Set up in 2012, SLIC was a partnership of commissioners and providers, with citizens, working together to improve the value of care in Southwark and Lambeth to help local people live healthier and happier lives. The partnership comprised the local GP Federations, the three local NHS Foundation Hospital Trusts - Guy’s and St Thomas’s, South London & Maudsley and King’s College - Southwark and Lambeth Clinical Commissioning Groups, Southwark and Lambeth local authorities and local people, supported by the Guy’s and St Thomas’ (GST) Charity.

The four-year £39.7m SLIC programme was funded by the partners, including a £10.6m grant from the GST Charity.

‘Integrating Care in Southwark and Lambeth: What we did and how we did it’ outlines the achievements of SLIC, highlights its key successes and challenges, and shares lessons learned. Not only does the report talk about what the Partnership did to integrate care, it explains how this was done, and includes a ‘Framework for Success’ as a resource for others undertaking similar programmes of transformation.

Headlines in the report include that:

•    During the four-year lifespan of SLIC (2012-2016), despite the population of Lambeth and Southwark aged 65 years and over growing by 5%, hospital admissions and bed days were stabilised, and residential and nursing home placements were reduced 61%
•    100% of patient records are now available to GPs and the three hospitals as a result of the Local Care Record, leading to 75% fewer calls from GPs to hospitals chasing information
•    14,500 people have benefitted from a Holistic Assessment (HA), creating with their GP a care plan to address their needs
•    1,500 calls to the Telephone Advice and Liaison (TALK) service have resulted in 720 people avoiding admission to hospital
•    75% of people attending Strength and Balance classes reported increased confidence and quality of life, and no hospital admissions due to falls

Of the 27 projects associated with SLIC - ranging from large-scale system change to low-cost, small-scale interventions that were co-designed by professionals, clinicians and citizens - 24 have now been mainstreamed or chosen for continued testing.

Successful interventions include the Falls Prevention project, which won the 2016 HSJ award for Value and Improvement in Community Health Service Redesign, and the Local Care Record, which provides such a high standard of patient information-sharing that it has received an official accreditation from EMIS Health – the first such system in the UK to achieve this distinction – and has been shortlisted for a national Patient Safety Award in the Best Emerging Technology and IT category.

As the report states in its foreword, the Partnership has relied on the “expertise, enthusiasm and commitment of its staff, clinicians and citizens to bring about change,” and SLIC’s achievements are “testament to the hard work of all involved.”

Other measures of success, says the report, are the experiences of the people SLIC has affected – both those who provide care and the recipients of it, from the 72-year-old woman who now has a reduced risk of stroke and a better quality of life due to an HA, to the professionals who are benefitting from the trust and relationships across the health and social care system SLIC has created, for example GPs and Age UK Care Navigators working together to provide a more holistic approach to care.

Describing SLIC as a “story of learning”, the report makes clear that integrating care was not without its challenges and that the partnership learned many lessons along the way – both what to do and what not to do. The report includes the SLIC Framework for Success, which condenses SLIC’s learning and sets out the 12 elements that need to be addressed in taking forward any programme of integrating care, including the importance of agreeing the balance between cost saving and improving outcomes and patient experience; the necessity of robust measurement and evaluation; the need to co-create and clearly communication a vision; and the role of effective governance.

The SLIC phase of the partnership ended on 31 March 2016 to make way for its next incarnation – the Southwark and Lambeth Strategic Partnership. The Strategic Partnership is using the lessons learned in SLIC to continue working towards achieving the vision of improving the value of care for local people.

Read the End of SLIC report: ‘Integrating Care in Southwark and Lambeth: What we did and how we did it’