Whole Systems Integrated Care (WSIC)
In Whole Systems Integrated Care, health- and social-care services work
together to create innovative ways to deliver person-centred care. It aims to
deliver high-quality care, to empower and support people to maintain
independence and to lead full lives as active participants in their community.
National pioneer process
North West London is one of fourteen areas chosen as "pioneers” in a
national programme developed to encourage ambitious and innovative approaches
to deliver integrated care in a person-centred way. The lessons from all the
pioneer programmes will be drawn on by other areas as they build their own systems
over the coming years.
Co-design is a process that brings together clinicians,
commissioners, the voluntary section, service users and other service providers
to develop an improved way of working. Using a co-design process helps build
care delivery that fully takes the service user perspective into account from
the get-go, helping to create a service that really meets people’s needs. For a
detailed how-to guide on co-design, see Chapter 3: How do we ensure service
users and carers are involved throughout?
Embedding Partnerships is the cross-cutting module of the Whole
Systems programme that focuses on co-producing integrated care with patients,
people who use services and carers. It is the means by which we worked together
as a team of professionals and lay partners to co-design our whole systems
solutions and tools.
A lay partner is a patient, a person who uses services or a carer
who is involved in the North West London Whole Systems Integrated Care
programme via Embedding Partnerships. Lay partners act as the guardians of the
vision for person-centred, joined-up health- and social-care and act to ensure
that all aspects of the programme benefit from the input of patients, people
who use services and carers from the very start. The term "lay partner” was
chosen by the individuals themselves.
Models of care
A model of care is the whole set of interventions and innovations
that combine to empower and support individuals and their carers. Partners
across North West London will need to come together to innovate new models of
Multi-disciplinary teams (MDTs)
MDTsshould bring together all of the relevant care
professionals, volunteers, and other partners who provide care for given
individuals, including the individuals and their carer(s). The professionals
included should be able to effectively look after the physical, mental and
social-care and support needs of the individuals covered. The vital part of an
MDT is to facilitate conversations, care planning, team working and referrals
amongst care professionals and their partners.
A personal budget is an amount of money allocated directly to
individuals for their own care, or managed by a local authority on behalf of an
individual. They are currently mostly used in social-care for FACS-eligible
individuals. A personal budget can either be managed by a care coordinator on
the individuals’ behalf, or used by individuals on whatever they think will
most improve their quality of life.
Capitation is a payment model where commissioners pay for all the
care a particular population group needs in one defined amount, and reward the
providers for meeting overall health targets, rather than for doing particular
services well. This should encourage care providers to innovate flexibly on
models of care to deliver care in the way that keeps people as well as
In a provider network is where multiple providers from across
health- and social-care work together with shared incentives to deliver
joined-up care. A provider network can create multi-disciplinary teams which
sit together, look after a shared list of people with shared goals and share
clear line management.
In a GP network, multiple GP practices join together to offer
services and realise economies of scale that would not be possible for single
practices. GP networks can join up with other providers to make a provider