How ICSs are working on prevention and early diagnosis – four case studies
The government is looking to the NHS to make three shifts – from treatment in hospital to closer to home, from analogue to digital and from treating illness to prevention. All have their challenges but the move towards prevention of ill-health in particular, requires a uniquely integrated way of working because many of the determinants of what makes us ill, fall outside of the health service, such as housing, poverty and unemployment.
This is why working in an integrated way with organisations across health, care and the voluntary sector is so important – working together to address the wider determinants of health can lead to prevention and early diagnosis, improving outcomes for patients and reducing pressure on the NHS.
Here are four examples of integrated care systems working together to deliver prevention and early diagnosis:
Using AI intelligence to reduce waiting time
Waiting for cataract surgery can see people’s vision deteriorate further and affect their everyday life – potentially making them less active. The Hampshire and Isle of Wight Integrated Care System has been using AI to ensure patients get faster access to surgery. An AI assistant – Dora – will ring patients to gather information about their medical history and then discuss what their options are around treatment, including where they can have their surgery done and how long they will have to wait at each location. Dora can also refer onto other sites, outside the ICB area, if that is what the patient prefers. Since Dora was first used in January 2024, average waits have dropped from 35 weeks to below 10 weeks with 92 per cent of patients in a recent survey saying they were “extremely satisfied.” She has also freed up nursing staff for other tasks.
New women’s health network
A new women’s health network in Luton has brought together NHS organisations, voluntary, community and social enterprise groups and – most importantly – the women whose lives they hope to improve. More than 100,000 women who live in the town – which has a particularly diverse population - can now engage with trusted providers on sensitive topics such as menstrual and reproductive health with the aim of getting them the right support in the right place.
Reducing falls with slipper swap
Falls among elderly patients at home are a major reason for hospital admissions with half of the other 80s expected to fall at least once a year. As well as risking poor outcomes from fractures of the neck of femur and other injuries, this can put a strain on both hospital and ambulance services. But inappropriate or worn footwear can be a factor in falls, Mid and South Essex ICS invited residents to a “slipper swap” where more than 1000 were given both new slippers with secure fastenings and robust soles and advice on fall prevention and home safety.
Targeting fuel poverty to improve health
Many chronic conditions are made worse by living in a cold house which is thought to contribute to thousands of preventable deaths a year – but keeping accommodation warm has become a challenge for many people over the last few years. Cheshire and Merseyside ICS used population health techniques to target some of those most at risk. Using data on fuel poverty hotspots and those most vulnerable to potential health harms allowed it to target two groups with a high risk of emergency admission to hospital – adults with COPD living in areas with high rates of fuel poverty and young children who had been prescribed with a salbutamol inhaler in the last 12 months. These groups were then helped to access Affordable Warmth finding from their local councils, as well as being offered a single point of contact for other council and health services.
