Can health and social care integration make long-term progress? Findings from key informant surveys of the integration Pioneers in England

All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and community health services, and involve local authorities and the voluntary sector. ICSs build on previous pilots, including the Integrated Care Pioneers in 25 areas from November 2013 to March 2018. This analysis tracks the Pioneers’ self-reported progress, and the facilitators and barriers to improve service coordination over three years, longer than previous evaluations in England. The paper aims to discuss these issues.

Integrated Care for Older People and the Implementation in the INSPIRE Study

The World Health Organization has published the Integrated Care for Older People, ICOPE handbook Guidance on person-centred assessment and pathways in primary care. This is an integrated individual care tool focused on the individual and healthy ageing. The ICOPE tool proposes step by step, a screening, a fine assessment, the development of a personalized care plan, its implementation and follow up and finally the consideration of the caregivers and community. The new Geroscience field is focusing on preventing age-related diseases, and should now investigate with the ICOPE tool the optimal maintenance of intrinsic capacity (IC) through mobility, cognition, psychology, vitality ...

Challenges in turning a great idea into great health policy: the case of integrated care

In the organization of health care and health care systems, there is an increasing trend towards integrated care. Policy-makers from different countries are creating policies intended to promote cooperation and collaboration between health care providers, while facilitating the integration of different health care services. Hopes are high, as such collaboration and integration of care are believed to save resources and improve quality. However, policy-makers are likely to encounter various challenges and limitations when attempting to turn these great ideas into effective policies. In this paper, we look into these challenges.

Towards a values framework for integrated health services: an international Delphi study

In order to organize person-centered health services for a growing number of people with multiple complex health and social care needs, a shift from fragmented to integrated health services delivery has to take place. For the organization of governance in integrated health services, it is important to better understand the underlying factors that drive collaboration, decision-making and behavior between individuals and organizations.

Portugal - Country case study on the integrated delivery of long-term care (2020)

This report describes the current state of the delivery of health and social long-term care services in Portugal. The country has advanced the policy framework to achieve integrated services delivery. However, fragmentation in the governance, funding and delivery renders the long-term care system inequitable and inefficient. The main policy pointers to further advance integration include consolidating pathways and care transitions, promoting joint training and multi-profile teams and addressing the shortage of human resources, migration and working conditions. 

Integrated care pilots in England revisited

The purpose of this paper is to explore the outcomes identified by the evaluation of the national programme of integrated care pilots (ICPs) in England in the context of wider policies designed to deliver integrated care and to consider the challenges presented to policy makers and evaluators in distilling usable insights to promote effective policy.

Also, this paper considers why evaluation findings appear limited in their impact on policy in the field of integrated care. Views as to how evaluation might be undertaken so that it generates actionable insights are advanced.

Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures

Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence is limited regarding how to best organize the delivery system to achieve higher value care. 

Implementing integrated care for multi-morbidity: analysis of experiences in 17 European programmes

Many countries are experimenting with new models of care provision and numerous integrated care programmes have been established internationally. However, little information is available on how to implement integrated care. The aim of this study was to provide more in-depth insights in the implementation of integrated care for developers and managers of integrated care programmes, policy makers, health insurers, and researchers.

Are patients ready for integrated person-centered care? A qualitative study of people with epilepsy in Ireland

The National Clinical Programme for Epilepsy (NCPE) in Ireland aims to deliver a holistic model of integrated person-centered care (PCC) that addresses the full spectrum of biomedical and psychosocial needs of people with epilepsy (PwE). However, like all strategic plans, the model encompasses an inherent set of assumptions about the readiness of the environment to implement and sustain the actions required to realize its goals. In this study, through the lens of PwE, the Irish epilepsy care setting was explored to understand its capacity to adopt a new paradigm of integrated PCC.  

Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services

The international medical journal, The Lancet, has published an article demonstrating the benefits of integrated and people-centred services in responding to the rise of HIV, tuberculosis (TB) and viral hepatitis in eastern European and central Asian countries of the WHO European Region.