National Framework for Children and Young People’s Continuing Care

This Framework (reviewed) is intended to provide guidance for clinical commissioning groups (CCGs) when assessing the needs of children and young people whose complex needs cannot be met by universal or specialist health services. CCGs have a legal responsibility for securing to a reasonable extent the health care which an individual needs, and this guidance is about the process which should be followed for the equitable discharge of that responsibility for children and young people with complex needs. This revision takes account of the new structures of NHS commissioning created by the Health and Social Care Act 2012 and the new integrated approach to the commissioning of services for children and young people with special educational need or disability (SEND) which the Children and Families Act 2014 introduced. In particular, where a child or young person has a SEND, which will often be the case, then CCGs and local authorities ...

European Observatory Venice Summer school 2016: "Primary care: innovating for integrated, more effective care"

The Observatory Venice Summer School 2016 is a one week intensive course aimed at senior and mid level policy makers, civil servants and professionals steering primary care services and those looking at strengthening care, its continuity and integrative functions within and beyond the health system.

What can a participatory approach to evaluation contribute to the field of integrated care?

Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground.

We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms.

While there is still much to learn about the benefits ...

Integrating Social Services and Home-Based Primary Care for High-Risk Patients

There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centred care and integration of health care with social services are the cornerstones of a more humane and efficient system. In the hope of stimulating further discussion and debate, the authors summarize existing viewpoints on how a home-centered system, which integrates social and medical services, might emerge in the next few years. 

What’s integration got to do with it?

Observations and Lessons from the Franciscus Gasthuis & Vlietland Study Trip to North-West London.

Service Delivery Models to Maximize Quality of Life for Older People at the End of Life: A Rapid Review

In an era of unprecedented global aging, a key priority is to align health and social services for older populations in order to support the dual priorities of living well while adapting to a gradual decline in function. The aimed of this review was to provide a comprehensive synthesis of evidence regarding service delivery models that optimize the quality of life (QoL) for older people at the end of life across health, social, and welfare services worldwide.

Elderly people, dependency and vulnerability in the coronavirus pandemic: an emergency for a social and health integration

The current SARS-CoV-2 pandemic (COVID-19) is affecting elderly people worldwide with greater incidence and severity. In Spain, 68% of all coronavirus hospitalizations correspond to those over 60 years of age. This work aims to highlight the evidence about the measures to be implemented through current and future guidelines. The need to prepare for action by implementing international protocols stand out. There is a trend towards biopsychosocial care of elderly people in all settings where they are, adapting care and personalizing decisions on hospital admissions, palliative care, among other criteria, to years adjusted to quality of life, as well as alternatives for monitoring and treatment of COVID-19 pathology and others existing in this population group. Measures to reduce the transmission of the virus through hygiene and social distancing are necessary, attending to biopsychosocial health of the elderly isolated. Intersectoral communication is proposed as innovative alternatives, and the use of technological tools ...

Policy by Pilot? Learning From Demonstration Projects for Integrated Care; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study”

Analysis of policy implementation for chronic disease in Belgium highlights the difficulties of launching experiments for integrated care in a health system with fragmented governance. It also entreats us to consider the inherent challenges of piloting integrated care for chronic disease. Sociomedical characteristics of chronic disease –political, social, and economic aspects of improving outcomes – pose distinct problems for pilot projects, particularly because addressing health inequity requires collaboration across health and social sectors and a long-term, life-course perspective on health. Drawing on recent US experience with demonstration projects for health service delivery reform and on chronic disease research, I discuss constraints of and lessons from pilot projects. The policy learning from pilots lies beyond their technical evaluative yield. Pilot projects can evince political and social challenges to achieving integrated chronic disease care, and can illuminate overlooked perspectives, such as those of community-based organizations (CBOs), thereby potentially extending the terms of policy ...