Vertical Integration

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The strength in this model lies in the approach that has made vertical integration a success with the reformed polyclinic. If adapted properly to improve horizontal integration, this hybrid model could prove to be a solid choice for the practice-based commissioning to adopt. Additionally, the top down approach shows a focus to fixing the larger principal issues so that the vision and aims of the organization are unified. On the other hand, this model does not seem to be a true hybrid combination. It focuses heavily on the methods used in the reformed polyclinic, but does not take many aspects of the outreach franchise. Also, while the top down approach can be effective at times, it can also be a negative experience with those at the top forgetting …show more content…
discussion paper, is a combination of the extended general practice organization and the district health system. The extended general practice has a strong emphasis on multidisciplinary work with horizontal integration through the multidisciplinary team and vertical integration through the gate-keeping specialists. The overall team is led by general practitioners, but at times can share leadership role with other team members. The district health system, an organization supported by the World Health Organization, has a viewpoint of healthcare for all. Vertical and horizontal integration is planned through committees and all clinics are under the supervision of doctors but run by nurses. The hybrid version of both of these organizations takes the community trust model of employed nurses and health professionals running hospitals and combines it with the multidisciplinary approach to form extended teams which leads to stronger horizontal …show more content…
Unlike with the first hybrid model, there is equal integration of both ideal organizations. They are combined under the same mission of healthcare for everyone while providing all the necessary care needed through the vision of a multidisciplinary team. They also take a bottom up approach. This can prove to be a strong method as it can advance learning and the development of the community at a basic level while also allowing for innovation. But the problems that plagued the organizations will only become more apparent with the hybrid model. In the district health system, they are held back by the bureaucratic nature of their organization. With the combination of two complex systems especially with a multidisciplinary approach, one can assume the level of bureaucracy will only rise. Bureaucracy can be a factor in stifling innovation and should be closely scrutinized before adoption of the hybrid
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