How commissioning can deliver a consumer-centric approach.
Helping people cope with complex issues, which may include factors such as housing, mental health, employment and child care, requires a coordinated response from health and human services agencies. Contemporary responses are centred around the needs of the individual, not the convenience of the provider, and reflect a deep understanding of the continuum of services available in the community.
‘Converged care’ or ‘converged support’ aims to solve this issue by bringing the social and health needs of an individual together. Commissioning can provide a structure and approach for providing converged care. By looking at the existing structure of the market (including purchasing and service delivery models), considering outcomes, and taking a customer centric perspective, new purchasing models focused on client need can be developed, and/or service paths can be re-designed and re-presented to the market.
Governments around the world are redesigning service systems and/or commission integrated care initiatives to improve consumer outcomes and maximise resources1. The majority of these initiatives are taking place at a single level of government, and can take a range of forms:
There are also a growing number of examples of governments taking a system-wide approach, reflecting a greater focus on consumer needs, including for individuals to be able to access services delivered by agencies in different sectors and across different levels of government.
When done well, converged care should mean that individuals interact with fewer professionals and have a better, more seamless, experience.
For governments and providers, there are considerable operational benefits of converged care, including:
Innovating on the Isle of Wight
On the Isle of Wight, off the south coast of England, the council, the health commissioning body and not-for-profit providers have established My Life A Full Life, a single point of access, integrated care and support program. The model includes:
Commissioning can play a crucial role in developing consumer-centric approaches to care by focusing on collaborative, intelligent service design, rather than traditional, siloed streams. But changing a system that has been in place for decades needs a rigorous approach to achieve long lasting results.
There are significant obstacles to overcome to achieve true convergence of support and care, not least cultural expectations, rigid professional frameworks, and the requirement for markets to adapt to new purchasing arrangements. The seven key areas we have identified should serve as a starting point. But continuing to invest in traditional, under-performing delivery models is not an option governments can afford to pursue. Gone are the days of one size fits all models; rather, providers must view the whole person and their unique stories and circumstances in order to provide the best care plan possible.