The principles below underpin our joint approach to integration outlined in Shifting the centre of gravity: making place-based, person-centred health and care a reality. They inform all our work helping partners to work across organisational boundaries to plan and deliver person-centred care and support.
We recognise that integration is not an end in itself but a means to deliver better health and wellbeing outcomes through effective, streamlined and coordinated care and support. Whether working at national, regional, system, place or neighbourhood level, effective partnership working on health, care and wellbeing should have the following elements:
- collaborative leadership
- subsidiarity - decision-making as close to communities as possible
- building on existing, successful local arrangements
- a person-centred and co-productive approach
- a preventative, assets-based and population-health management approach
- achieving best value.
Collaborative local leadership to develop a shared vision, culture and values to support transformation. All partners – providers, councillors, commissioners, clinicians, social care professionals, community representatives, experts by experience and others - are respected and valued. They understand their own contribution and support the contributions of other partners to a shared vision and goals to improve health and wellbeing.
Subsidiarity - System leaders are committed to making decisions at the most local level, as close as possible to the communities that they affect. Accountability mechanisms for new health and care partnerships will build on existing structures, including health and wellbeing boards and local authorities, clinical commissioning groups and provider organisations. New governance structures are open, transparent and locally accountable.
Building on what already works locally - Many areas have already developed partnership working to plan and deliver joined-up, person-centred services. Where these are working effectively, build on them and consider adding partners. All areas should be enabled to develop their own neighbourhood, place and system level approaches according to what is appropriate for them, rather than adhering to a rigid national blueprint.
A person-centred approach - All partners plan and deliver care and support with individuals and, where they wish, with their families, to achieve the best health and wellbeing outcomes. Co-production is a core principle, ensuring that the people who use services are at the centre of design and delivery of services.
A preventative, assets-based population health approach that maximises health and wellbeing, independence, and self-care in or as close to people’s homes as possible in order to reduce their need for health and care services. This will improve health and wellbeing for all, including addressing inequalities and the wider determinants of health.
Achieving best value – All partners to work together to ensure that the delivery of care and support represents the best value, including, of securing the best possible health and wellbeing outcomes using safe and high quality services, while ensuring the sustainable use of resources.
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