Integration of NHS and council teams is a success
More people are being supported to return home from a hospital stay, or to avoid having to be admitted, thanks to the integration of NHS and council teams.
The teams from Derbyshire Community Health Services and Derby City Council had worked alongside each other for years.
In May 2024 they formally merged through transferring 169 city council staff to the NHS trust, joining around 100 DCHS staff.
Together they created the new unified Community First service, providing health and social care support as one service.
It means the teams can support more people, said Dom Fackler, Head of Community First.
Their first year together was focused on maintaining service standards, while setting up new joint systems and processes.
Now into their second year, the joint team – and the people they support – are seeing the benefit of the integration, says Dom.
“Our first year was about building and stabilising the service.
“That covered areas like setting up a single staffing roster, a single system for care plans and electronic records and single sets of procedures.
“They have been implemented only this November and they are having an impact now.
“That means we can be more flexible, more responsive, and that we can simply see more people to support them to stay at home.
“For example, if we have staff sickness we have a single team to draw on to provide cover, whereas previously we couldn’t have the council staff fill in for an NHS staff vacancy, or vice versa. So it makes us more resilient.
“It also means we have a single route into our team. For example, if a GP makes a referral or a hospital wants to discharge a patient, they work with just one team now instead of two.”
The healthcare staff at Community First include roles such as occupational therapists, physiotherapists and nurses, while the former council staff include social workers, Care Act assessors, Perth House staff and a community based reablement service.
In Derby the team supports many people at Perth House, which provides short-term residential reablement services for people following a hospital stay but who are not yet well enough to back to living independently in their own home.
The team also supports many people in their own homes to stay well and avoid a crisis event that may lead to hospital admission.
Analysis of 2024/25 performance measures shows that service levels were broadly similar to the previous year.
The performance areas measured included the total numbers of referrals managed, number of referrals to Perth House and whether they required further support or care following discharge.
The team is also seeing early indicators that it seems to be paying private providers for less care and managing more of it within the NHS service, but more monitoring will be carried out to confirm this.
Dom added: “It has been a great deal of work to integrate the two teams and there was a risk that it would have destabilised the service and produced worse outcomes for patients.
“But that didn’t happen and that is an initial success in itself and the foundation for more opportunities to improve.”
The team’s successes were highlighted through a video story at DCHS’s recent Better Together annual celebration event, where staff spoke about the positive impact of the change.
In the video Serena Taylor, a physiotherapist working as a Clinical Service Manager, says:
“It’s bringing together what we already did as two separate teams. It’s been a real change in culture, to think about strengths-based assessments and how we put that person at the centre of our care in a social care way as well as a health way.”
Jane Haywood, a social worker, says:
“Social care does add value to community health services. We bring a different perspective. We look at the bigger picture…on that person’s social needs, their economic needs, housing.
“Together with our health partners we work holistically with the person and their family to improve their health outcomes, their wellbeing and their quality of life.”