St Helens Cares: making integrated care a reality

Professor Sarah O'Brien profile picture

17 September 2018

Professor Sarah O'Brien
Clinical Accountable Officer
St Helens Clinical Commissioning Group


In 2016 key partners (including the local authority, NHS, CCG, providers, police, housing, fire and voluntary sector) in St Helens recognised that health, social care and community services in the borough were being delivered within a fragmented and complex system and for many years had been working independently of each other. The partners realised that integration and closer working was necessary to tackle the challenge of cost and demand to improve outcomes for local people. 

As a result a new strategic board was set up called Peoples board which set a vision to become 'the most effective borough based partnership in the country with enhanced stewardship by those who are democratically elected.' As part of its development work, the Peoples Board agreed a vision to improve people's lives in St Helens, together, by tackling the challenge of cost and demand.

Since that time St Helens has moved at pace on the integration agenda. The vision was for integrated strategic commissioning and since 1 June this year I have been in a joint local authority and clinical commissioning group post as the strategic director peoples services and accountable officer with an integrated senior management team covering all aspects of health commissioning, public health and children and adults social care. 

The vision in St Helens is for providers of health and social care to work in a more integrated and collaborative manner with social care and health provision coming together in a 'lead provider' model. Four localities have been established and there are already examples of different ways of working on the ground with community nurses and GPs working together differently. Social prescribing is being piloted and locality management and leadership teams are also being established. 

The vision in St Helens is for providers of health and social care to work in a more integrated and collaborative manner with social care and health provision coming together in a 'lead provider' model.

Professor Sarah O'Brien    Clinical Accountable Officer


Another key success to date is the creation of Contact Cares - a large multi-disciplinary (nursing, housing, social care, therapists) 'front door' team based in the grounds of the local acute hospital with the aim of preventing admissions and facilitating timely discharge. This is starting to have a really positive impact.

Another unique feature of the work in St Helens is the role of the social housing provider which is part of both the strategic board and executive subgroup for St Helens Cares who are contributing to innovative schemes on the ground. 

There have been and still are many cultural, organisational, process and statutory challenges to the integration agenda but with a shared commitment, vision and passion for better outcomes the leaders and staff in St Helens are tackling these and making a difference.

There have been and still are many cultural, organisational, process and statutory challenges to the integration agenda but with a shared commitment, vision and passion for better outcomes the leaders and staff in St Helens are tackling these and making a difference.

Professor Sarah O'Brien    Clinical Accountable Officer


It is too early to have evidence of sustained impact but early indications are that it has:

  • Reduced delayed discharges
  • Reduced length of stay on the interim care ward
  • Improved admission avoidance

 

Sarah joins us on day two of our annual conference and exhibition this year to discuss the work of St Helens in more detail and explore how we can make integrated care a reality. To view the programme or to book your place visit the website.

About the author

Professor Sarah O'Brien profile picture

Professor Sarah O'Brien
Clinical Accountable Officer

Professor Sarah O’Brien, PhD, BA hons, RN, Dip Health, FHEA is a registered nurse who until 2013 combined a clinical and academic career as a diabetes nurse consultant. She moved into nurse leadership and was appointed chief nurse at NHS St Helens CCG in 2014 and accountable officer in 2016. Since June, she has been in a joint council and CCG role overseeing health and social care for St Helens.