abstract: 'Background: Significant challenges exist within primary care services in

  the United Kingdom (UK). These include meeting current demand, financial

  pressures, an aging population and an increase in multi-morbidity.

  Psychological services also struggle to meet waiting time targets and to

  ensure increased access to psychological therapies. Innovative ways of

  delivering effective primary care and psychological services are needed

  to improve health outcomes.

  Summary: In this article we argue that integrated care models that

  incorporate behavioural health care are part of the solution, which has

  seldom been argued in relation to UK primary care. Integrated care

  involves structural and systemic changes to the delivery of services,

  including the co-location of multi-disciplinary primary care teams.

  Evidence from models of integrated primary care in the United States of

  America (USA) and other higher-income countries suggest that embedding

  continuity of care and collaborative practice within integrated care

  teams can be effective in improving health outcomes. The Behavioural

  Health Consultant (BHC) role is integral to this, working

  psychologically to support the team to improve collaborative working,

  and supporting patients to make changes to improve their health across

  management of long-term conditions, prevention and mental wellbeing.

  Patients'' needs for higher-intensity interventions to enable changes in

  behaviour and self-management are, therefore, more fully met within

  primary care. The role also increases accessibility of psychological

  services, delivers earlier interventions and reduces stigma, since

  psychological staff are seen as part of the core primary care service.

  Although the UK has trialled a range of approaches to integrated care,

  these fall short of the highest level of integration. A single short

  pilot of integrated care in the UK showed positive results. Larger

  pilots with robust evaluation, as well as research trials are required.

  There are clearly challenges in adopting such an approach, especially

  for staff who must adapt to working more collaboratively with each other

  and patients. Strong leaderss needed to assist in this, particularly to

  support organisations to adopt the shift in values and attitudes towards

  collaborative working.

  Conclusions: Integrated primary care services that embed behavioural

  health as part of a multi-disciplinary team may be part of the solution

  to significant modern day health challenges. However, developing this

  model is unlikely to be straight-forward given current primary care

  structures and ways of working. The discussion, developed in this

  article, adds to our understanding of what the BHC role might consist

  off and how integrated care may be supported by such behavioural health

  expertise. Further work is needed to develop this model in the UK, and

  to evaluate its impact on health outcomes and health care utilisation,

  and test robustly through research trials.'
affiliation: 'Dale, H (Corresponding Author), Lynebank Hosp, Dept Psychol, NHS Fife,
  Halbeath Rd, Dunfermline KY11 4UW, Fife, Scotland.

  Dale, H (Corresponding Author), Univ St Andrews, Sch Med, Med \& Biol Sci Bldg,North
  Haugh, St Andrews KY16 9TF, Fife, Scotland.

  Dale, Hannah, Lynebank Hosp, Dept Psychol, NHS Fife, Halbeath Rd, Dunfermline KY11
  4UW, Fife, Scotland.

  Dale, Hannah; Lee, Alyssa, Univ St Andrews, Sch Med, Med \& Biol Sci Bldg,North
  Haugh, St Andrews KY16 9TF, Fife, Scotland.'
article-number: '97'
author: Dale, Hannah and Lee, Alyssa
author-email: hannahdale@nhs.net
author_list:
- family: Dale
  given: Hannah
- family: Lee
  given: Alyssa
da: '2023-09-28'
doi: 10.1186/s12875-016-0485-0
eissn: 1471-2296
files: []
journal: BMC FAMILY PRACTICE
keywords: 'Primary Care; Behavioural Health; Psychology; Collaboration;

  Integration; Biopsychosocial; Health Inequalities; Prevention; Service

  Improvement'
keywords-plus: 'UK PRIMARY-CARE; RANDOMIZED CONTROLLED-TRIAL; SHARED DECISION-MAKING;

  COLLABORATIVE CARE; GENERAL-PRACTICE; MENTAL-HEALTH; QUALITATIVE

  EVALUATION; COMPLEX INTERVENTIONS; DEPRESSION; MULTIMORBIDITY'
language: English
month: JUL 29
number-of-cited-references: '100'
papis_id: 4051d51310a71e7ac9d16c069d82c2c1
ref: Dale2016behaviouralhealth
times-cited: '14'
title: 'Behavioural health consultants in integrated primary care teams: a model for
  future care'
type: article
unique-id: WOS:000380826100002
usage-count-last-180-days: '0'
usage-count-since-2013: '25'
volume: '17'
web-of-science-categories: Primary Health Care; Medicine, General \& Internal
year: '2016'