Blockley David, Stirrat Gordon, Alexander Kirsty, Phillips Sabrina
Civil Engineering, University of Bristol, Bristol, UK.
Obstetrics & Gynaecology, University of Bristol, Bristol, UK.
Glob Adv Health Med. 2022 Aug 5;11:2164957X221117112. doi: 10.1177/2164957X221117112. eCollection 2022.
A recent UK Government draft Heath White Paper follows the NHS England long term plan when it states that NHS England requires "a new framework that builds on changes already being made as well as building in the flexibility to support the system to tackle challenges of the future". At present the structure of Health and Social Care Services UK reporting to Government seems unhelpfully complex and opaque.
The purpose of this paper is to contribute to the building of a new framework using a generic approach to identify and use 'systemic processes' to facilitate the integration of Health and Social Care services in NHS England and elsewhere.
We highlight some of the critical issues that are currently hindering integration and set out a new way of understanding the structure of NHS England through an 'inside-out' analysis of systemic processes.
We describe and give three examples of existing systemic processes as 'Consulting a patient', 'Enhancing a Single point of access' - to mental health services and 'Delivering health and social care services England'.
Rethinking the interactions between existing organisations could arguably bring considerable benefits including cost savings, better co-ordination, less 'admin' stress on staff where the work is done and provide more organisational adaptability in an uncertain future. Ultimately our suggestions are aimed at helping people to deliver better patient care - the impelling purpose of all health and social care services.
英国政府近期的一份《健康白皮书》草案遵循了英国国民保健制度（NHS）英格兰的长期计划，其中指出NHS英格兰需要“一个新框架，该框架在已做出的变革基础上构建，并具备灵活性以支持该系统应对未来的挑战”。目前，向政府汇报工作的英国健康与社会护理服务的结构似乎复杂且不透明，毫无益处。
本文旨在通过一种通用方法构建一个新框架，以识别和运用“系统流程”，促进NHS英格兰及其他地区的健康与社会护理服务整合。
我们着重指出当前阻碍整合的一些关键问题，并通过对系统流程进行“由内而外”的分析，阐述一种理解NHS英格兰结构的新方式。
我们描述了现有的“咨询患者”“加强心理健康服务的单一接入点”以及“在英格兰提供健康与社会护理服务”这三个系统流程示例。
重新思考现有组织之间的互动可能会带来诸多益处，包括节省成本、更好地协调、减少工作人员在工作地点的“行政”压力，并在不确定的未来提供更强的组织适应性。最终，我们的建议旨在帮助人们提供更好的患者护理——这是所有健康与社会护理服务的首要目标。
