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BLOG POST: Two weeks in England - Reflections on the Journey to Integrated Care

I’ve just returned from a fortnight spent in England meeting with policymakers, providers, commissioners and local innovators from across the country. 

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I came away impressed and excited about the future for integrated health and social care.  The positive energy in communities from London to Liverpool to Manchester to Rochdale is ever present.  The stakeholder community is not only coming to terms with the move to integration but more importantly, are embracing it with real enthusiasm.  That is a very positive sign, though a long road lies ahead.

A second major reflection is that the ever-present issue of Brexit looms large even when it's not discussed.  The uncertainty caused by the current situation – regardless of your views – can be debilitating.  It’s hard to plan for the future when the fate of a large percentage of your workforce is so uncertain.

Despite all the uncertainty, I was impressed by the level of optimism for the future I found during my travels. 

Regional leaders such as Jon Rouse (Greater Manchester Combined Authority) inspired the World Healthcare Congress – Europe with a compelling vision of health and social care that is integrated, person-centered and committed to value.  While he clearly articulated the challenges we will face, he also described a possible future in which people and communities are far better served.  Jon is a global treasure, and his words inspire me as an American who sees health and social care in precisely the same way. 

Inspiration was abundant in Liverpool where Jane Tomkinson is using an unusual position – CEO of a speciality hospital – to drive an internal as well as external conversation about population health improvement.  While Liverpool has its share of challenges, I’m very excited to see where the community goes in the future given the strong leadership offered by Jane and her fellow leaders across the health economy.

I was also hugely impressed by the leadership and innovation I saw in local communities across the country. 

A site visit to Rochdale demonstrated the power of local leadership to drive integration supported by rigorous QI.  Deborah Lyon and the rest of the team has created integrated, neighbourhood teams that are breaking down bureaucratic barriers and getting health and social care services to those who need them most.  What I found most compelling was how motivating the work was for the nurses and social workers on the frontline who see how their integrated approach is helping meet individual and community needs every day. 

Perhaps the best workforce strategy – Brexit or no Brexit – is to actually empower the health and social care frontline so that it gets even more satisfaction from its work, which in turn will help with both recruitment and retention.

England is on its way to integrated health and social care.  Everyone from government policymakers to frontline change agents are demonstrating this commitment.  Their journey is the same path that New York and other US states are on, as well as other nations such as New Zealand and Australia. 

The journey is long and challenging, but after spending two inspiring weeks in England, I feel even stronger that it’s the right path for all of us to follow.

Jason Helgerson