Developing a joint outcomes contracting model for integrated health and social care for older people

Purpose

Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. This paper describes a three phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long term conditions, and based on joint outcomes.

Design/methodology/approach

A participative mixed-method approach for the development of the contracting model was used; this consisted of 1) a literature review, 2) a design phase drawing on consensus method through stakeholder discussions and 3) an international validation phase.

Findings

The final contracting model consists of four overarching and interrelated core elements: (i) outcomes; (ii) partnership, collaboration and leadership; (iii) financial: incentives and risk; and (iv) legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria.

Research limitations/implications

While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed.

Practical implications

The paper concludes with reflections on the way forward for local development and implementation.

Originality/value

There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focuses on joint outcomes. This research bridges the gap but recognises