Working Clinically in an Integrated Way

By completing this theme you will be able to demonstrate the ability to:

  1. Take part in one clinical activity where you are working differently, in a more integrated way.
  2. Understand your role and the role of other health professionals through working and learning together.
  3. Apply leadership principles to enable effective inter-professional collaboration and learning.
  4. Give examples of more integrated clinical working.

What you need to do over the course of the programme:

  • Attend the PICH seminar(s)
  • Take part in one integrated clinical activity that is different to your normal practice, for example a Learning Together clinic. If an activity does not currently exist consult with your champion or colleagues or PICH faculty about what might be possible to put into practice. If you are interested in participating in learning together clinics – please visit the programme’s website, or email If you are working in NW London and are interested in participating in integrated working with the connecting care for children project (cc4c) please email the Connecting Care for Children manager – and look at the website.
  • Visit a patient with a long term condition at home. Ask questions of the family so you can understand how they manage and what their challenges are. What helps? What is difficult? (This activity  overlaps with the patient experience theme)
  • Reflect on your experience of this activity – what have you learnt? Use the Form for trainee to complete for each theme (on the PICH website) – or a tool of your choosing  –  to record your reflections.

Ideas for you to consider within this theme:

  • What are the advantages of working and learning in a more integrated way? Compare your training with other health professionals?  Did your training have a similar focus to theirs – should it be similar?
  • Integration is about links. How can paediatricians link into primary care and form networks with primary care health professionals and vice versa?
  • Integrated working across services is variable. What examples of integrated working are going on in your area? Reflect on what is done really well and why this might be the case. Will you change how you might approach an issue or do something differently as a result of seeing this integrated working in practice? Does this knowledge have any impact on your project?  What do you think our roles and responsibilities will be in the future?

Ideas that have already been developed – to stimulate your thinking:

Case Study 1

Work jointly with GPs to manage patients

Epsom St Helier Integrated Child Health clinics.  An integrated team runs monthly clinics in several GP practices. Children are referred in from surrounding GP practices for an integrated clinic. The team decide who is best placed to see children within the team. A team meeting before and after each clinic decides who is seen and by whom. Some are seen by a GP with a special interest in child health, others by a Consultant Paediatrician. Others may be managed by a Specialist Health visitor.

Case Study 2

See patients in a setting that works better for them

The paediatric diabetes team at Hillingdon see teenagers at school-based clinics. The young people get a full consultation, no different to what would happen in the hospital, without missing much school. The professionals get a chance to link up with staff at the school. The other young people at the school start to see diabetes as ‘normal.’

Further reading:

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