Health Integration Teams (HITs) are groups that bring together health professionals, managers, commissioners, researchers, patients and the public to tackle local health priorities.
HITs aim to improve service delivery and the health of people in and around Bristol. Each of the 20 HITs has a particular focus, for example:
- reducing avoidable admissions to hospital
- child injury prevention
- chronic kidney disease
- drug and alcohol addiction
- pain management
Bristol Health Partners is a strategic collaboration between the city’s three NHS trusts, three clinical commissioning groups, two universities and its local authority. Bristol Health Partners has developed and supported HITs since July 2012. The HIT model is unique to Bristol and had not previously been evaluated.
We aimed to develop a detailed description of how the HIT model works, and how it is expected to deliver improvements.
What we did
We examined 140 documents about HITs and their development. We also interviewed 10 key individuals who had been involved in developing the model.
How we involved people
We met regularly with our collaborators at Bristol Health Partners to agree how to carry out the research and to make sure we took account of all the relevant information.
We presented our early results to the Bristol Health Partners Board and the working group which focused on evaluation of the HITs. These presentations allowed us to check and discuss our ideas with stakeholders, to ensure that the final results would be reliable and relevant for those who would be using them. They also provided our partners with timely updates on what we were finding, so that they could take account of this in their ongoing work.
What we found and what this means
Our research identified four areas which successful HITs need to develop. Two of these areas relate to processes, and two are related to outcomes:
- Whole system engagement: Actively seeking to engage all those who have a stake in the area of practice in which the HIT is being established
- Collaboration: Developing the most productive ways of working together in order to achieve the HIT’s aims and objectives
- Integration: Organisations and individuals brought together to produce care which is joined up and fit-for-purpose
- Innovation: Successfully exploiting new ideas and novel ways of delivering services or interventions through the introduction or application of new approaches
This deeper understanding of how the HITs work can be used to strengthen the model and improve the way HITs are supported.
Our description of the model may also be of interest to those involved in setting up similar arrangements elsewhere, and to researchers in the social and implementation sciences with an interest in their evaluation.
The results of our research are feeding into Bristol Health Partners’ plans for supporting and evaluating the HITs to ensure they deliver on local priorities.