What?

SLIC was a partnership between local GPs, the three local NHS foundation hospital trusts (Guy’s and St Thomas’, South London and Maudsley, and King’s College Hospital NHS Foundation Trusts), Southwark and Lambeth clinical commissioning groups, the two boroughs’ local authorities, as well as the voluntary and community sector, and people of Southwark and Lambeth.

Since it was established in 2012, SLIC helped communities and professionals work together to ensure a joined up health experience for local people. Through partnership working, SLIC aimed to:

• improve health and wellbeing through effective prevention
• support individuals and communities to feel and be well, to identify their needs early and respond quickly, and to help them to better manage their health conditions
• significantly improve people’s experience of care and ensure more joined up care
• address the fierce operational and financial pressures the local health and care system is under.

We helped stimulate the creation of SLIC with a £10.6 million grant over three years, and we are actively involved in the initiative. Core to SLIC is what we believe is needed to improve health and care – to challenge traditional thinking and encourage radical change in the way services are delivered so that care can be truly integrated and people are supported to take control of their own health and wellbeing.

SLIC focused on creating services that empower people to manage their lives well; see people as whole people, taking all of a person's medical, psychological and social needs into account; and are proactive and preventive so that services offer support in the right place and at the right time.

How?

To improve the quality and value of care across Lambeth and Southwark, SLIC worked towards achieving a healthcare system that works together as one integrated system with one budget.

The SLIC strategy was about new relationships and radical culture change. It required SLIC partners to work innovatively and in ways that would enable health and care staff to put people at the heart of care. Professionals were supported by SLIC to think creatively about a wide range of responses to a person’s needs. The approach required staff to operate across the local networks and care settings, rather than through orthodox hierarchies and within the traditional confines of buildings.

SLIC’s efforts to integrate care included:

• focusing on providing the right care in the right place at the right time
• supporting the sustainability of the health and social care system
• moving resources (money and staff) between the partnership to support improved partnership working
• supporting health and social care professionals, and local people, to share, learn and develop together.

The partnership helped to develop  deep relationships across the NHS, local authorities and communities to break down silos and to radically redesign models of care, commissioning approaches and provider partnerships.

Specific projects designed to enable high-quality integrated care included holistic assessments, community multi-disciplinary teams, simplified discharge and falls prevention.

Why?

In Lambeth and Southwark, despite having many of the UK’s most talented clinicians, professionals and leaders, the current health and care system makes it difficult for organisations and professionals to work together, and care is mostly focused on treatment rather than prevention.

The health and care system is also under great financial strain. If the system continues as it is, demand will outstrip supply and it will become financially unsustainable.

It is only by working together that the highest quality of care can be provided, at the same time as ensuring the best possible value for money.

Integrated care is about ensuring a joined-up experience for local people, through different health and care organisations working together. It means that health and care services take into account the person’s physical, mental health and social care needs, leading to a better, more coordinated, service. It also allows people to take more control over their own wellbeing, enabling self-care and people being involved in decision-making about their care.

SLIC was developed so that there can be a collective response to the challenges the health and care system faces, a joint approach that effectively integrates care is the best way to provide the highest quality care for the local population.  

Who?

SLIC was a partnership between local general practices, the three local NHS Foundation hospital trusts (Guy’s and St Thomas’ NHS Foundation Trust, South London and Maudsley NHS Foundation Trust and King’s College Hospital NHS Foundation Trust), Southwark and Lambeth clinical commissioning groups, Southwark and Lambeth local authorities, and people in Southwark and Lambeth.

Benefits and impact

‘Integrating Care in Southwark and Lambeth: What we did and how we did it’, a report published at the end of the programme, outlines the achievements of SLIC, highlights successes and challenges, and shares lessons learned. The report reveals that, as a result of the programme, which run from 2012 until March 2016:

• Hospital admissions and bed days were stabilised, and residential and nursing home placements were reduced 61% (this is despite the population of Lambeth and Southwark aged 65 years and over growing by 5%)
• 100% of patient records became available to GPs and the three NHS Trusts as a result of the Local Care Record, leading to 75% fewer calls from GPs to hospitals chasing information and improving the service for patients treated by different local professionals
• 14,500 people 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, 24 have been mainstreamed or chosen for continued testing
• Trust and relationships improved among local health and social care professionals