Norfolk and Waveney Built-in Care System to be launched

You nearly actually did not discover it, however this week noticed one of many greatest shake-ups within the historical past of our native healthcare system. DAVID HANNANT explains what occurred, why it issues and what it means for you

On Tuesday, it will likely be 74 years to the day for the reason that basis of the Nationwide Well being Service.

It’s unlikely that in seven many years time we will probably be commemorating the occasions of July 1, 2022, in fairly the identical method.

However it was a fairly vital second within the historical past of the well being system nonetheless.

For on the stroke of midnight on Friday, well being and social care in Norfolk and Waveney turned an ‘built-in care system’, run by a very new organisation, NHS Norfolk and Waveney.

As so typically within the well being service, the language provides little trace of the significance.

Certainly, it’s extra more likely to actively repel the person or girl on the road.

The jargon provides the general public little sense of what has occurred and why it issues for all of us.

So, what does this ugly, bureaucratic phrase – ‘built-in care system’ – really imply and why is it being launched?

The shake-up follows the introduction of a brand new regulation, the Well being and Social Care Act 2022.

It’s not restricted to our area. Comparable modifications have been made throughout the nation.

The ambition behind it is an enormous one: to make healthcare extra environment friendly and to rework the total method of the system, to alter the main target to ‘well being’, in addition to ‘sickness’.

So what’s an built-in care system?

The thought is that any further, all of the organisations accountable for well being and social care in our area have come collectively underneath one umbrella.

From Friday, there’s a single organisation – NHS Norfolk and Waveney – accountable for pooling the sources of those areas and deciding the place essentially the most pressing wants lie.

These areas embrace not solely hospitals, GP practices and psychological well being items, but in addition care properties and domiciliary care, native authorities, housing and the voluntary sector.

How does this differ from the present system?

Presently, the well being care system is break up into suppliers – those that run the person components of the system – and commissioners, who’re accountable for understanding how cash is spent.

Till now, the Norfolk and Waveney Medical Commissioning Group (CCG) has managed the area’s NHS finances, deciding how and the place this cash is spent.

Whereas well being trusts have their very own budgets too, they depend on the CCG to buy many of the key issues they want.

In the meantime, the area’s grownup social care system is managed by Norfolk County Council and operated by non-public suppliers.

What is going to change?

A key change is that the CCG has ceased to exist, with its tasks absorbed by one a part of NHS Norfolk and Waveney, known as the Built-in Care Board (ICB)… when you had been hoping the change may imply a discount in jargon and acronyms you’ll be disenchanted.

The ICB will probably be made up of representatives from all of the separate arms of well being and social care – together with the area’s three hospital trusts, the psychological well being belief, neighborhood care trusts and Norfolk and Suffolk county councils.

The board will probably be accountable for deciding how the NHS’s £2bn Norfolk and Waveney finances is spent throughout the area and making certain all components of the system work correctly.

There will even be one other a part of the brand new organisation, the built-in care partnership (ICP) – informed you concerning the acronyms – which is able to decide how well being and social care will probably be supplied.

Why is that this taking place?

The change is being made as a result of a brand new regulation being launched – which has been introduced in with the goal of constructing well being and social care run extra easily.

Well being bosses say the Covid-19 pandemic highlighted the advantages of organisations working nearer collectively and this method goals to construct on this.

Who’re the principle figures?





Tracey Bleakley, NHS Norfolk and Waveney chief govt, and Patricia Hewitt, the organisation’s chairman

– Credit score: NHS Norfolk and Waveney

The native built-in care board will probably be chaired by Patricia Hewitt, a former Labour secretary of state for well being.

She served as a part of Tony Blair’s cupboard as well being secretary between 2005 and 2007 and chaired the area’s sustainability and transformation partnership – a earlier scheme to hitch up well being and social care.

Tracey Bleakley has been appointed because the chief govt officer-designate for the ICB.

The ICP will probably be chaired by Conservative councillor Invoice Borrett, who’s at the moment Norfolk County Council’s cupboard member for grownup social providers.

How does this assist me?

One of many major targets of the system is to ensure individuals should not have to elucidate their conditions to multiple well being or care skilled.

Mrs Hewitt mentioned a technique this will probably be achieved is thru new digital ‘care information’, which everyone within the area may have.

“On a really sensible degree, the brand new shared care information will probably be a digital document that any organisation concerned within the system can entry and add to,” she mentioned.

“We have already seen an instance of this in motion with a trial that allowed paramedics within the ambulance belief to entry GP information, which means after they arrive to a callout they already know all concerning the affected person and may cope with their wants faster.

“The thought is so that individuals will not want to inform their tales a number of occasions to totally different organisations.”

What is going to the system’s major priorities be?


Patricia Hewitt, who will be chairing the new integrated care board


Patricia Hewitt, who will probably be chairing the brand new built-in care board

– Credit score: NNUH

Mrs Hewitt mentioned the shake-up will see a serious change in emphasis in the best way individuals are cared for within the area.

She mentioned: “To me, this appears like the primary time that the NHS in Norfolk and Waveney will probably be focussed on well being, in addition to sickness.

“It is not going to simply be taking a look at what your GPs and your hospitals can do for you – but in addition serious about individuals’s household conditions, are they lonely, can they eat nourishing meals, all points of wholesome dwelling.”

Tracey Bleakley, chief govt of NHS Norfolk and Waveney, mentioned the three major priorities had been:

  • Assuaging pressures on hospitals, ambulances and GPs,
  • Bettering psychological well being providers,
  • Guaranteeing individuals obtain “the correct care in the correct place”.

She mentioned: “We can’t draw back from the very fact individuals are having to attend lengthy occasions for ambulances and hospital remedy and there’s immense stress on our GPs and hospitals generally.

“There are issues we will do within the quick time period, however now we have to additionally take a look at the long run.”

How will the change assist the area’s failing psychological well being providers?

Ms Bleakley mentioned collaborative working can be key to serving to enhance the care individuals obtain for psychological well being within the area.

She mentioned: “The problems with psychological well being care shouldn’t be merely about one organisation – it’s a systemic drawback that now we have to handle.”

She mentioned that previously individuals have slipped by the online whereas transferring between totally different types of look after psychological well being – which is one thing the brand new method of working wanted to handle.

She added: “It needs to be about ensuring individuals can entry the providers they want and the way we will maintain them from reaching a degree of disaster.

“There have been occasions the place individuals can solely get assist as soon as they’re at that time – after which they be part of an extended ready checklist for these whereas they’re already in disaster.

“Our goal is to have the ability to wrap round individuals and provides them the correct remedy on the proper time.”

How will this assist beat ready occasions?

Whereas there will probably be no straightforward resolution to mounting ready lists and pressures on the well being system, the concept is {that a} joined-up system will cut back calls for on hospitals by stopping individuals wanted them as continuously.

Ms Bleakley mentioned: “Previously, every totally different organisation has tried to guard entry so the individuals that basically want their care can get it.

“This has meant individuals can discover it tough to get a GP appointment or a hospital appointment. We need to make it a lot simpler for individuals to get the care they want.

“If we get that proper individuals will be capable to keep more healthy and be capable to keep of their communities longer.”

And the hope is that the extra individuals who will be cared for in neighborhood, the less might want to go to hospital or rely closely on well being providers – thus easing the mounting stress.

Has this been tried earlier than?

Not precisely. Nevertheless, varied efforts have been made up to now to convey well being and social care nearer collectively.

In 2013, the Coalition authorities pledged that joined-up well being and social care can be “the norm” by 2018.

A part of this effort later noticed related preparations arrange, referred to as sustainability and transformation partnerships.

Nevertheless, this shake-up is a much more vital change, with the 2 sectors, in essence, changing into one.

Will it work?

The most important query of all. And the one we simply can’t reply but.

The challenges going through the well being and care techniques are acquainted to each one in every of us.

Simply as acquainted are top-down initiatives emanating from Whitehall meant to make issues higher.

Whether or not this one will fare any higher stays to be seen.

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