The integration of health and social care services is the way most practitioners see the future of care delivery in the community. For too long we have managed services that make no sense to our patients, their families and carers. Patients don't want to tell their story and provide a health and social history to multiple practitioners. They expect that their records will be combined and shared between services in the community-in the same way as there is one record of their care in the hospital, albeit that multiple practitioners contribute to it.
The utopia of community care for nurses is that all community health and social care practitioners are employed locally by the same umbrella organisation, that patients have one record and that a high-quality seamless nursing and social care service is delivered by the right practitioner with the right skills to all patients.
There are many significant challenges with such an integrated approach to care in the community. Firstly, the budgets for health and social care. A significant amount of will and leadership are needed before we arrive at a position where budgets are shared and priorities agreed, but some local areas with are already exploring this.
The Association of Directors of Adult Services and the NHS Confederation recently carried out a survey which demonstrates that there are still barriers to be overcome, such as the need for shared data and IT systems. The NHS Confederation has a wealth of information on the issue of integration on their website: http://tinyurl.com/ooazync which I urge you to review.
The King's Fund has also just launched a commission on the future of health and social care in England in which the opportunities and challenges of integration will be fully explored and recommendations made: http://www.kingsfund.org.uk/topics/integrated-care
There is already evidence of savings and, where integrated services exist, there are reductions in delayed hospital discharges and avoidable hospital admissions. This is a logical consequence of integrated services and community nurses would support this approach. We want what is best for our patients, who like to be cared for at home and want to avoid hospital admission,when possible.