The design of healthcare delivery in England as primary (services delivered by general practices) and secondary (services delivered by hospitals) is as old as the NHS itself. Despite longstanding discussions about, and changes to, the NHS infrastructure, in an attempt to deliver more joined up or integrated healthcare, the models of primary and secondary care have fundamentally remained unchanged.
Healthcare systems worldwide are facing many similar pressures: from increasing public expectations of a modern healthcare system; through people living longer with a variety of different illnesses; to the cost of health care technology required to deliver high quality services. In light of these pressures local decision makers are faced with the challenge of designing new joined up or integrated care models of higher value for their local communities.
Many health care economies responded to a NHS wide call for examples of innovative integrated models of health and social care. Models showing most promise will now be funded to support their delivery. These new models of care are called Vanguards; our proposal is concerned with a particular type of Vanguard called Multispecialty Community Providers (MCPs) which aim to provide comprehensive integrated care outside of a hospital setting.
Whilst Vanguards are new, the underlying efforts to deliver different models of care whether in the NHS or internationally are not. In order for Vanguards to learn from, and improve on, what has already been tried and described, we need to understand previous and current models of providing integrated care. To this end we have designed an approach based on accepted rigorous methodologies to combine or synthesise the existing reported knowledge (the evidence) of integrated models of care that are similar to MCPs.
In our ‘evidence synthesis’ we also wish to explore the characteristics of the 14 chosen MCP Vanguards, to understand what can work for them and what can be applied elsewhere. To ensure the relevance of this evidence synthesis we also propose to check emerging findings with NHS staff working within Vanguards and members of the public drawn from a Vanguard population. We propose to deliver the final report of the evidence synthesis alongside practical tools to support local decision makers in making full use of the findings and applying them to their local settings.
Our team plans to draw upon the inherent advantages of being based in an NHS setting, supported by skills and experience in planning, managing and undertaking rapid analytical work, and supported by methodological expertise from a dedicated NIHR HS&DR Centre. We have existing relationships with the national New Care Models team who are overseeing the Vanguards and a number of local Vanguard delivery teams. Together we will ensure a direct application of the findings to Vanguard practice.
mcpsynthesis 