How one of Norman Lamb's pioneers is integrating health and social care

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This article originally appeared in Guardian Healthcare Network.

Macmillan Cancer Support and clinical commissioning groups in Staffordshire are transforming cancer and end-of-life care

In January 2012, Macmillan Cancer Support and clinical commissioning groups in Staffordshire and Stoke-on-Trent started to collaborate on the concept of a programme to integrate cancer care locally. The organisations came to a mutual understanding of the scope of the programme, its deliverables and outputs.

The initial focus was on commissioning cancer pathways across the north of the county. Following wide consultation with local chief executives at all secondary care providers, Macmillan agreed to invest in and support the programme. Thereafter, commissioning groups in South Staffordshire also expressed an interest in collaborating on the project and the scope was expanded geographically and widened to include end-of-life care.

The Staffordshire and Stoke-on-Trent Transforming Cancer and End-of-Life Care Programme is now a partnership between Macmillan Cancer Support and nine commissioners from across health, social care, Public Health England and NHS England.

Apart from the obvious scope and scale of the programme, what is unique is the approach it is taking to lead health and social care integration. It is one of the Department of Health's 14 national pioneer sites leading the way in this field. The aim is to support health and social care commissioners to shift the focus of practice from providers and individual interventions to one that encompasses the whole patient journey.

There are three core components to the programme:

Co-design the best outcome-based integrated health and social care pathways based on the needs of patients and carers for all cancers and for end-of-life care for people with all types of long term conditions
Change the way both cancer and end-of-life care services are commissioned so that patient care is contracted and managed through a single (or prime) provider who will be held accountable for the entire patient experience and clinical outcomes. This enables a transformation in service design and delivery focused on the patient and outcomes along an integrated pathway, not on individual providers
Support the prime provider to manage change within the contracts to ensure that outcomes are achieved and that the project becomes self-funding within the first two years.

The programme is testing and challenging the system and is an example of true pioneering work. It is doing this by involving patients, carers, providers and commissioners in the design and working with them to make any changes that are needed.

This is an illustration of the value of a partnership between the voluntary sector, health, social care and patients in commissioning services and how this collaborative approach helps to put patients' needs and outcomes first.

Moving away from short-term contracts to the awarding of up to a 10-year contract allows for innovation and service reform. Reviewing the best financial incentives ensures that they align with achieving the outcomes of service delivery and differing pathways of care.

Those of us involved in this programme are well aware of the challenges ahead, such as moving to longer contracts and payment mechanisms to facilitate the move to integrated pathways. We also face the day-to-day challenges of managing competing priorities within health and social care.

Key to the success of this programme, and the integration of health and social care on a national scale, is understanding what patients and carers need. We must be continually engaging with the public to do this and keep co-design as the main priority.

Justine Palin is Macmillan Cancer Support programme director in Staffordshire & Stoke on Trent.

For more information about the Pioneers programme, and the support TLAP is offering visit Integrated Care and Support: our shared commitment.