The Leadership of Co-Production in Health and Social Care Integration in Scotland: A Qualitative Study

The involvement of citizens in the production and creation of public services has become a central tenet for administrations internationally. In Scotland, co-production has underpinned the integration of health and social care via the Public Bodies (Joint Working) (Scotland) Act 2014. We report on a qualitative study that examined the experiences and perspectives of local and national leaders in Scotland on undertaking and sustaining co-production in public services. By adopting a meso and macro perspective, we interviewed senior planning officers from eight health and social care partnership areas in Scotland and key actors in national agencies. The findings suggest that ...

The state of integrated care systems 2021/22

An assessment of integrated care systems' progress in 2021/22, based on the views of system leaders across England

Though they have been in operation for several years in many parts of the country, integrated care systems (ICSs) across England are set to become new statutory bodies from July 2022. This will represent a significant shift in how health and care services are planned and delivered – away from the model of fragmentation and competition followed in previous decades (and reinforced through the Health and Social Care Act 2012), and towards one of collaboration between services.

“ICSs are a revolution in ...

Introducing The Lancet Global Health Commission on financing primary health care: putting people at the centre

Impact of ‘Enhanced’ Intermediate Care Integrating Acute, Primary and Community Care and the Voluntary Sector in Torbay and South Devon, UK

Intermediate care (IC) was redesigned to manage more complex, older patients in the community, avoid admissions and facilitate earlier hospital discharge. The service was ‘enhanced’ by employing GPs, pharmacists and the voluntary sector to be part of a daily interdisciplinary team meeting, working alongside social workers and community staff (the traditional model). Enhancing IC through greater acute, primary care and voluntary sector integration can lead to more complex, older patients being managed in the community, with modest impacts on service efficiency, system activity, and notional costs off-set by perceived benefits.

White paper. Health and social care integration: joining up care for people, places and populations.

This white paper is part of the government’s commitment to transform the delivery of care in England following the Prime Minister’s announcement on reforms for health and social care through the Build Back Better: Our Plan for Health and Social Care.

This white paper is part of a wider set of mutually reinforcing reforms:

• the adult social care reform white paper
• the Health and Care Bill, and reforms to the health and care system

It sets out measures needed to make integrated health and social care a universal reality for everyone across England regardless of their condition and ...

The Peterborough Exemplar: a protocol to evaluate the impact and implementation of a new patient-centred, system-wide community mental healthcare model in England

Community mental healthcare has significantly grown since de-institutionalization. Despite progress, service fragmentation and gaps in service provision remain key barriers to effective community care in England. Recent mental healthcare policies highlighted the need to transform service provision by developing patient-centred, joined-up community mental healthcare. In response to policy guidance, a system-wide community mental healthcare model was developed in Peterborough (England). The "Peterborough Exemplar" is based on two main pillars: (1) the creation of knowledge exchange pathways to strengthen interorganizational relationships, and (2) the development of new, accessible community services addressing existing service gaps. 

Integrated Care - Defining for the Future through the Eye of the Beholder

The central defining features of integrated care which cuts across all stakeholders (people and communities, individual providers, a system of organisations, and policymakers) are continuity and coordination. Continuity occurs temporally and coordination occurs spatially. For the person at the centre of care, their experience is seamless across formal/informal care, professional, organisational and sectoral boundaries and continuous over time. For providers, they design care to effectively manage transitions from one profession, organisation or sector to another over multiple episodes of care. For policymakers, integrated care requires them to ensure that the wider context supports continuity and coordination and does not ...

Integrated care: putting principles into practice and becoming the paediatrician of the future

Acute hospital paediatric services and separate primary care paediatricians, with links often fragmented, there is evidence that this delivers neither seamless nor equitable care. Integrating care around population needs is the direction of travel. The recent UK restructure into integrated care systems intends to facilitate improved collaboration and equity of health and care across geographies. Within child health, the Royal College of Paediatrics and Child Health’s (RCPCH) 2040 project describing future models of care has the ‘development of integrated care for children and young people at scale across the UK’ as a key goal.

Caregiving and Caregiver Health 1 Year into the COVID-19 Pandemic (CUIDAR-SE Study): A Gender Analysis

The COVID-19 pandemic has highlighted the importance of informal care and shown that women continue to shoulder the brunt of responsibilities in this area. In this study, we analyzed differences in caregiving and self-perceived health in a group of informal male and female caregivers 1 year into the COVID-19 pandemic. Compared with male caregivers, female caregivers were more likely to experience increases in caregiving intensity and burden and a decline in self-perceived health as a result of the pandemic.

Terms of engagement for working with patients in a person-centred partnership: A secondary analysis of qualitative data

Evidence is emerging of the potential of person-centred approaches to create partnerships between professionals and patients while also containing healthcare costs. This is important for enhancing outcomes in individuals with complex needs, who consistently report poor experiences with care. The shift towards person-centred care (PCC) is, however, a radical departure from the norm, with increased expectations of both professional and patient.