The intention of this document is to inform professions, policy makers and commissioners about the options available for moving care ‘closer to home’ and to develop the concept of ‘Teams without Walls’.
Teams without Walls is an integrated model of care, where professionals from primary and secondary care work together in teams, across traditional health boundaries, to manage patients using care pathways designed by local clinicians.
- Government policy initiatives should lead to care that is excellent, safe and affordable. Boundaries that hinder effective collaborative working between healtprofessionals should be removed.
- A jointly commissioned model of integrated healtservices should be provided by primary and secondary care working together. This would significantly reduce the potential for unhealthy competition between primary care trusts and hospital foundation trusts and contractual and cultural conflicts.
- Clinical leadership is required for successful commissioning.
- The incentives/disincentives of Payment by Results need to be re-balanced to bring integrated specialist and generalist care closer to the patient’s home.
- Future healthcare should build on the successes of today, using the better policy initiatives as necessary but rejecting others that create barriers to effective change.
In summary, there will need to be:
- a clear vision and set of NHS values, shared by all, crossing traditional professional and organisational boundaries
- an alignment between those commissioning, providing and regulating services
- investment in leadership, innovation and the spread of audit and learning, to drive a new culture of continuous improvement
- removal of boundaries between primary and secondary care.