Paul Hamlyn Chair of Surgery, Imperial College, London, UK.
Int J Integr Care. 2012 Apr-Jun;12:e43. doi: 10.5334/ijic.814. Epub 2012 May 18.
In recent years England has introduced a number of initiatives to promote more integrated care. Two contrasting examples are the GP-led health centres and the Integrated Care Pilots announced in the interim and final reports, respectively, of the NHS Next Stage Review in 2007-2008. The GP-led health centres were proposed as a very centralised, prescriptive approach where the aim was that all the NHS should adopt the same model of facilitating integration through co-location. Integrated Care Pilots, on the other hand, looked to the NHS to suggest their own solutions to improve integration, resulting in a variety of solutions tailored to the needs of localities. Although the results of the evaluation of the Integrated Care Pilots have been equivocal, this bottom-up approach must be the right way to foster integrated care. Long-term commitment to integrate care is needed, as well as more exploration of integration between primary care and hospitals.
近年来，英国推出了多项举措来促进更全面的医疗服务。两个截然不同的例子是 2007-2008 年 NHS 下一阶段审查的中期和最终报告中分别宣布的由全科医生领导的医疗中心和综合护理试点。由全科医生领导的医疗中心是一种非常集中的、规范性的方法，其目的是所有国民保健制度都应采用通过共同定位促进整合的相同模式。另一方面，综合护理试点则寄希望于国民保健制度提出自己的改进整合的解决方案，从而形成了各种针对当地需求的解决方案。尽管综合护理试点的评估结果好坏参半，但这种自下而上的方法必须是促进综合护理的正确途径。需要对整合护理进行长期承诺，同时还需要进一步探索初级保健和医院之间的整合。
