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Integrated care: a story of hard won success

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3529 (Published 31 May 2012) Cite this as: BMJ 2012;344:e3529

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Re: Integrated care: a story of hard won success

Dr Elizabeth Paice and her team are to be congratulated for setting up integrated care for patients with diabetes and those over 75 years in these turbulent times. The paediatric unit at Northwick Park Hospital was opened in 1971 and by 1977 we were providing an integrated service for the 60,000 children of Harrow(1). Subsequently, our annual reports showed that a wider more appropriate spectrum of services were being provided, the length of stay was reduced and the number of admissions fell(2).

In the mid 1990s disintegration began with the withdrawal of the paediatric social work support to a central office and a few years later the child and adolescent psychiatric services moved to a site at the other end of the borough. The close daily contact between essential professionals for planning and implementing effective and efficient patient care was lost.

Dr Elizabeth Paice achieved integrated care, but how will she prevent disintegration?

(1) Valman HB, Liberman MM,. Snow P, Wilson J,Samuel OW, and Lindsay-German J. Child Health in integrated Child Health Service. Health Trends 1977: 9, 30-33
(2) Valman HB. Working for Children: development of the Paediatric Unit at Northwick Park. London: Harris, 2006

Competing interests: No competing interests

18 June 2012
Bernard Valman
Retired consultant paediatrician
Northwick Park Hospital
105 Bridge Lane London NW11 0EU