Proponents of coordinated care should focus on quality improvement, not cutting costs, conference hears

Patients with complex and chronic conditions need not endure fragmented care, but making the system less of an obstacle course for them is never simple, a conference at the King’s Fund in London on 24 October was told.

Better coordination of care is about negotiating new relationships and respecting local differences, and no single plan is suited to all situations, speakers at the conference argued. It often requires charismatic leadership and can falter when enthusiasts retire or move elsewhere.

The default position for health systems everywhere was one of fragmented financing, inadequate care for people with long term conditions, and poor collaboration between health and social care professionals, said Margaret MacAdam, an expert in the care of the elderly at the University of Toronto.

She cautioned against the normal UK pattern of running pilot studies and of evaluating them too soon. It takes a long time to achieve results, she said, and participants who know that the scheme …