Cures for the Fragmented Care of Older People

system reviews health and care services

The first six ‘System Reviews’ of health and care services for older people were recently published by the CQC. They reveal a picture of some progress, but still too much fragmentation.

The fragmentation leads to familiar issues: delayed transfer of care and older people not being able to access the care they need in their own home, even when this setting would deliver the best outcome.

At the extremes, lack of coordination between health and care services can lead to avoidable and unintentional harm.

Commenting on the Interim Report, Professor Steve Field, Chief Inspector of General Practice and Integrated Care, said:

“… despite these good intentions, the ‘whole system approach’ that focuses on integrated and person-centred care is not being realised as best as it could. We have identified three themes that could act as a barrier to integration: how providers and commissioners work together; capacity, market supply and workforce issues; and, the need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing.”

Lack of IT systems that span health and social care continues to be an issue. Another recurring theme seems to be the difficulty in rapidly brokering  care packages. People could then return to their normal place of residence as soon as they are well enough.

Several complex issues impede fully integrated and person-centred care. Capacity and workforce issues will not be easily resolved given current funding and pay rates. But there’s no reason why the physical brokering of care packages should stand in the way of progress.

eBrokerage is a cloud-based solution that can be used by health and care professionals to collaborate over and agree individual care needs. Once needs are assessed and agreed, new care packages are quickly uploaded to the system and preferred providers automatically alerted. The entire process is fully online and accessible on any device – from posting packages to bidding and award. It can be done in hours rather than days or weeks.

Several commissioning bodies have already adopted the solution. They have seen the number of unfilled care packages reduce dramatically. The system also supports good practice throughout the process and helps to bring health and care services closer together around the needs of individuals.

We realise that eBrokerage won’t solve all of the issues identified in the system reviews of health and care provision. But equally it’s hard to foresee a comprehensive solution that doesn’t have the simplification of the commissioning and brokerage process at its core.

If you would like to know more about how eBrokerage simplifies the commissioning process please contact Dan Farrell-Wright or Richard Bedford on 01626 798 890 or email

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