How Warrington has created a new integrated model of care that has been designed and implemented seamlessly by multiple partners across a system

There is a long history of attempting to integrate health and care across Warrington, a need which has arisen due to unfavourable health outcomes for some of the population and increased financial pressures. Until recently, these attempts have been unsuccessful. Warrington Together is a partnership that was created in 2017 which works with stakeholders from across the health and care system to integrate care, improve outcomes for residents and eradicate areas of duplication. This paper reviews how an integrated model of care has been designed and implemented in partnership with colleagues from across the health and care system in Warrington and how the culture has changed to allow a more collaborative way of working. Resources have been invested in the development of relationships from across traditional organisational boundaries. Colleagues have been encouraged to work in a ‘badgeless’ way, considering the needs of the residents of Warrington over their own organisational interests. A series of workshops and development sessions have been held with leaders over the past 12 months to develop a culture of mutual respect and understanding between partners and to create a shared vision and values. Leaders from across the system have been closely involved and own the development of all key documents and processes, such as the vision, a strategic business case and governance structure. This has led to a sense of shared ownership and has created a commitment to implement integrated care. The main aims for the new model of care are: Creation of neighbourhood hubs with co-location of multi-disciplinary integrated care teams. Reducing non-elective attendances and admissions to hospital and providing care closer to home. Increased digital capacity and capability with the creation of the Warrington Care Record. Promotion of assets and asset based working within the community. Reducing dependence on health and care services and moving towards a culture of self-care and independence, where appropriate. These aims will be delivered by senior leaders thinking and working collaboratively as a system. Key signs that signal success include: The hospital trust voluntarily signing up to a ‘lite’ version of the Capped Expenditure Process. Commitment from a number of partners across the system to the development of the Warrington Care Record, a digital enabler that will enable a virtual patient record. £500k funding being awarded from the Cheshire and Merseyside Health and Care Partnership as a result of a bid written by the Warrington Together team. Commitment being given from all partners to prioritise work on frailty, including the creation of a frailty hub that involves a number of partners. Implementation of integrated community teams commencing in late 2018. Key factors in this work include giving leaders the autonomy to act and make decisions on behalf of their organisations. This has been crucial to driving change at pace. Having a diverse range of stakeholders has also proven to be an advantage as it has encouraged different ways of thinking and has resulted in collaborative, innovative solutions.