A departmentalised and fragmented health service is inefficient. Information flows are weak and the patient experience suffers. Collaborative care (also known as integrated care and shared care) is a trend in healthcare reform. It can improve care in terms of quality, efficiency and the patient experience.
At one extreme, collaborative care is a complex country-wide initiative, as the NHS has set out in its 5 Year Forward View. It also describes smaller scale initiatives between GP practices, working together in federations.
A GP federation shares responsibility for delivering high quality, patient-focused services for its patients. These services are typically more responsive, easier to access and closer to patients' homes.
Many GP practices share patient records and appointments to enable collaboration. We've seen many benefits, summarised here as three reasons why you should consider collaborative care:
1. Reduce GP workload
Moving services, such as mental health and physiotherapy, out of the GP practice reduces pressure on GPs and their staff. Modern, interoperable IT systems enable these shared services:
- Centralised diaries allow receptionists at the practices to book appointments with these services, just as they would if the service was still in the practice.
- Sharing patient records with the service providers gives the carers and clinicians an understanding of the patient's health.
- Service providers can add notes about their interventions and send them back to the patient's GP.
In South Wales, a cluster of GP practices opened a primary care hub and employed a mental health therapist. The cluster uses Vision 360 to share patient records with the therapist and manage their appointments.
Receptionists at all the cluster practices have real-time access to the therapist's diary. They can book 30-45 minute appointments for their patients at any time and from any place. During consultations, the therapist can access the patient’s record and add notes about their interventions. Any information they add is available to the patient's GP.
2. Improve access
Federated services can improve access for patients. The most obvious example being extended appointments at evenings and weekends. It wouldn't be possible for each practice to provide extended hours appointments in isolation, but it's viable for a federation. The Richmond GP Alliance was the first federation in the country to use end-to-end interoperability to enable record and appointment sharing between practices using Vision and EMIS systems.
In Letham, a rural village in Scotland, a nurse-led clinic is improving support for local people with long-term health conditions. Patients can visit the local clinic in their village instead of travelling to the nearest town to see their GP. It's reducing GP workload and making a big difference to patients too, especially those who were having home visits because they are village-bound rather than house-bound.
3. Safe care
For collaborative care to be safe, the clinicians and carers working at the shared services must understand their patients’ medical histories. They need access to the patient records held in the IT systems at the GP practices.
The nurses in Letham use Vision 360, which maintains a central copy of the patient records. It is securely hosted on the N3 network and is kept up-to-date throughout the working day. Nurses working at the clinic can view and add to these shared patient records while they are with patients.
Karen Fletcher, the Lead Nurse at the Angus Health & Social Care Partnership said;
"It was important to ensure clinical safety. What if I didn’t know a patient had an allergy for example? Vision 360 solves this problem. Now, we can see any patient in the village and know about their health history because we have sight of their medical records."
- View the infographic to find out how Vision's record sharing works.
- Discover the secrets of sharing agreements.
- Download the Letham nurse-led clinic case study.
- Download the case study to find out how pharmacists in NHS Highland are working in collaboration with GP practices to reduce travel time for polypharmacy medication reviews.
- Download the white paper to see how the Richmond GP Alliance implemented an interoperable solution for extended hours appointments.