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A report produced in 2012 by Bolton LInK (Local Involvement  Network) (now Healthwatch) that examined GP access by 'marginalised' communities. This data should be of interest to all those involved in how users access primary care services.

This briefing summarises NICE's recommendations for local authorities and partner organisations on improving access to health and social care services for vulnerable people who do not routinely use them, promoting equitable access for all. It is particularly relevant to health and wellbeing boards.The guidance can be accessed and downloaded by clicking here:

Stopping smoking at any time has considerable health benefits and for people using secondary care services, there are additional advantages including shorter hospital stays and fewer complications. Secondary care providers have a duty of care to protect the health of, and promote healthy behaviour among, people who use, or work in, their services.  This guidance aims to support smoking cessation, temporary abstinence from smoking and smokefree policies in all secondary care settings. It recommends:

  • Strong leadership and management to ensure premises remain smokefree.
  • All hospitals have an on-site stop smoking service.
  • Identifying people who smoke, offering advice and support to stop.
  • Providing intensive behavioural support and pharmacotherapy as an integral component of secondary care.
  • Integrating stop smoking support in secondary care with support provided by community-based services.
  • Ensuring staff are trained to support people to stop smoking while using secondary care services.
  • Supporting staff to stop smoking or to abstain while at work.
  • Ensuring there are no designated smoking areas or staff-facilitated smoking breaks for anyone using secondary care services.

You can view the full guidance by clicking here:

A summary report of useful reports and toolkits aimed at Health and Wellbeing Boards and those who work closely with them. Many of these toolkiuts and reports are already part of Bolton's Health Matters.

AGMA (Association of Greater Manchester Authorities) have produced an overview of the current provision of integrated care in Greater Manchester (inclusive of current costs) as well as the potential benefits of the 'New Delivery Models'. This report includes: case for change; current state of and costs of provision; range and scope of change - both locally and nationally; delivery plan as well as a cost-benefit analysis of the potential changes.

This report is a must-read for all of those involved in the integrated care programme in Bolton.

An evidence summary produced by AQuA (Advancing Quality Alliance). AQuA is dedicated to improving healthcare across the NHS in the North West. Formed in recognition that improvement has to be led from the front-line rather than be centrally imposed, AQuA’s aim is to accelerate the pace of improvement and to help good practice to spread rapidly. Please visit and register with them here:

Key Points

  • Evidence relating to the theory of large scale reconfigurations and integrated care is plentiful, robust evidence of the impact at population (system) level is very limited.
  • To achieve the level of change that is required by political and economic imperatives, multi agency work for whole populations, such as the Total Place programme  seem essential. In the UK, The Kings Fund found insufficient evidence to assess and evaluate the outcomes of system integration. A ‘leap of faith’ is therefore required since large scale reconfigurations are known to take many years to demonstrate an impact.
  • Scale, pace and expert overall co-ordination is required to achieve major improvements in population health and well-being. Segmentation of the whole population, with targeted interventions for sub-populations / condition groups is recommended. There is UK evidence of service change having a major impact on health outcomes for condition specific high volume sub-populations, such as diabetes, trauma, stroke, mental health and older people. In older people’s care there is evidence of filtering of the many improvement initiatives that have been tried, and identification of the few that have a measurable impact.
  • Identifying and systematically addressing the enablers of system level reconfiguration is critical.
  • The role of the system level leadership and implementation team becomes one of orchestrating multiple service level reconfigurations, addressing the system enablers and ensuring that each sub population reconfiguration delivers the required results. Continuous evaluation as part of the overall system reconfiguration is essential to gauge progress against projected goals.

Evaluating Integrated and Community Based Care outlines the main community-based interventions that have been evaluated and their impact, and identify nine points that may help those designing, implementing and evaluating such interventions in future.

This publication provides a compilation of Accident and Emergency (A&E) data in England, to give a broad picture of the patient journey through A&E. This should be of interested in those commissioners involved in developing integrated care. The resource can be viewed by clicking here and selecting the resource you would like to download.


The insights in these packs will support local discussion about prioritisation and utilisation of resources. The aim of this pack is to help local leaders to improve healthcare quality, outcomes and efficiency by providing the first phase in the NHS Right Care approach - “Where to Look”. That is, where to look to help CCGs to deliver value to their populations. They are also the first product CCGs will receive as part of the new planning round for commissioners - a vital part of NHS England’s ‘Call to Action’ where everyone is being encouraged to take an active part in ensuring a sustainable future for the NHS.

This report presents the findings from a two-year research project funded by Aetna and the Aetna Foundation, which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. It elicits some key lessons and markers for success to help identify how care co-ordination might be transferred from the UK to the US context.

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