Integration and Collaboration: Clinically-Led Initiatives in South Devon and Torbay

The journey –

This programme aims to build on an already strong local history of collaboration and engagement to drive forward some ambitious integrative changes to the local healthcare system across a range of identified pathways.  It involves a long-term, systematic culture change.

The programme has concentrated initially onthree care pathways (cardiology, diabetes and rheumatology) to showcase and test cases for change in order to be able to create much greater integrated systems of care in the future.



Outcomes are not yet fully identified, as this is both a large-scale and a long-term change programme.  However, there are already demonstrable improvements to patient experience and outcomes within the defined pathways.


Patient setting

In-patient Out-patient Community based
Mental health Chronic illness  x Cross-systems  x


Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   x End of life


Information, tools and techniques used

This is a clinically led programme.  The formation of Clinical Pathway Groups enables focused change management and redesign to be led by a multi-disciplinary focus group, using up to date dashboards to inform quality and financial improvements across a range of workstreams within each defined pathway



South Devon Healthcare NHS Foundation Trust, South Devon and Torbay Clinical Commissioning Group, Torbay Council, Devon County Council, NHS Devon plus a range of voluntary, charitable and not-for-profit organisations and patient participation groups.



The programme started in 2011 and is still ongoing, although each pathway consists of multiple workstreams, some of which receive in-year focus over others.


Contact details and further information

Louise Hardy,

Posted on Jan 16th, Cat: , , , Tags: , Comments: Comments are off for this post

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