2023-09-28 14:46:10 +00:00
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abstract: 'Background: Significant challenges exist within primary care services in
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the United Kingdom (UK). These include meeting current demand, financial
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pressures, an aging population and an increase in multi-morbidity.
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Psychological services also struggle to meet waiting time targets and to
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ensure increased access to psychological therapies. Innovative ways of
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delivering effective primary care and psychological services are needed
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to improve health outcomes.
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Summary: In this article we argue that integrated care models that
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incorporate behavioural health care are part of the solution, which has
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seldom been argued in relation to UK primary care. Integrated care
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involves structural and systemic changes to the delivery of services,
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including the co-location of multi-disciplinary primary care teams.
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Evidence from models of integrated primary care in the United States of
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America (USA) and other higher-income countries suggest that embedding
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continuity of care and collaborative practice within integrated care
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teams can be effective in improving health outcomes. The Behavioural
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Health Consultant (BHC) role is integral to this, working
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psychologically to support the team to improve collaborative working,
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and supporting patients to make changes to improve their health across
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management of long-term conditions, prevention and mental wellbeing.
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Patients'' needs for higher-intensity interventions to enable changes in
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behaviour and self-management are, therefore, more fully met within
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primary care. The role also increases accessibility of psychological
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services, delivers earlier interventions and reduces stigma, since
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psychological staff are seen as part of the core primary care service.
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Although the UK has trialled a range of approaches to integrated care,
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these fall short of the highest level of integration. A single short
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pilot of integrated care in the UK showed positive results. Larger
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pilots with robust evaluation, as well as research trials are required.
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There are clearly challenges in adopting such an approach, especially
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for staff who must adapt to working more collaboratively with each other
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and patients. Strong leaderss needed to assist in this, particularly to
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support organisations to adopt the shift in values and attitudes towards
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collaborative working.
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Conclusions: Integrated primary care services that embed behavioural
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health as part of a multi-disciplinary team may be part of the solution
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to significant modern day health challenges. However, developing this
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model is unlikely to be straight-forward given current primary care
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structures and ways of working. The discussion, developed in this
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article, adds to our understanding of what the BHC role might consist
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off and how integrated care may be supported by such behavioural health
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expertise. Further work is needed to develop this model in the UK, and
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to evaluate its impact on health outcomes and health care utilisation,
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and test robustly through research trials.'
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affiliation: 'Dale, H (Corresponding Author), Lynebank Hosp, Dept Psychol, NHS Fife,
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Halbeath Rd, Dunfermline KY11 4UW, Fife, Scotland.
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Dale, H (Corresponding Author), Univ St Andrews, Sch Med, Med \& Biol Sci Bldg,North
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Haugh, St Andrews KY16 9TF, Fife, Scotland.
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Dale, Hannah, Lynebank Hosp, Dept Psychol, NHS Fife, Halbeath Rd, Dunfermline KY11
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4UW, Fife, Scotland.
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Dale, Hannah; Lee, Alyssa, Univ St Andrews, Sch Med, Med \& Biol Sci Bldg,North
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Haugh, St Andrews KY16 9TF, Fife, Scotland.'
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article-number: '97'
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author: Dale, Hannah and Lee, Alyssa
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author-email: hannahdale@nhs.net
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author_list:
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- family: Dale
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given: Hannah
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- family: Lee
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given: Alyssa
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da: '2023-09-28'
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doi: 10.1186/s12875-016-0485-0
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eissn: 1471-2296
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files: []
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journal: BMC FAMILY PRACTICE
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keywords: 'Primary Care; Behavioural Health; Psychology; Collaboration;
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Integration; Biopsychosocial; Health Inequalities; Prevention; Service
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Improvement'
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keywords-plus: 'UK PRIMARY-CARE; RANDOMIZED CONTROLLED-TRIAL; SHARED DECISION-MAKING;
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COLLABORATIVE CARE; GENERAL-PRACTICE; MENTAL-HEALTH; QUALITATIVE
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EVALUATION; COMPLEX INTERVENTIONS; DEPRESSION; MULTIMORBIDITY'
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language: English
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month: JUL 29
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number-of-cited-references: '100'
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papis_id: 4051d51310a71e7ac9d16c069d82c2c1
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ref: Dale2016behaviouralhealth
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times-cited: '14'
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title: 'Behavioural health consultants in integrated primary care teams: a model for
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future care'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000380826100002
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usage-count-last-180-days: '0'
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usage-count-since-2013: '25'
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volume: '17'
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web-of-science-categories: Primary Health Care; Medicine, General \& Internal
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year: '2016'
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