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.

Providing person-centred care for people with multiple chronic conditions: protocol for a qualitative study incorporating client and staff perspectives

Chronic conditions are associated with over one-third of potentially avoidable hospitalisations. Integrated care programmes aim to help people with chronic conditions to self-manage their health, thus avoiding hospital admissions. While founded on principles of person-centred care, the experiences of people with multiple chronic conditions in integrated care programmes are not widely known. This study explores how person-centred care is incorporated into an integrated care programme for people with multiple chronic conditions.

Levers for integrating social work into primary healthcare networks in Austria

The integrated healthcare of patients with support needs in primary healthcare in Austria has insufficient structural and procedural features in terms of the quality and security of care. The aim is therefore to develop solution- and patient-oriented services that take into account both the patients’ requirements as well as the medical, nursing, therapeutic and economic perspectives. 

Are Clients Satisfied with Integrated Care? Enhancing Client Feedback on Discharge from a Domiciliary Based Multidisciplinary Integrated Care Service

The Integrated Care Programme for Older People has supported the development of integrated care services at pioneer sites in Ireland, each developed to meet local needs. Patient Reported Experience Measures (PREMs) have been used to evaluate user experience in intermediate care in the United Kingdom. This project aimed to evaluate client experience of a domiciliary based, multidisciplinary, integrated care service.

Can Organisational Culture of Teams Be a Lever for Integrating Care? An Exploratory Study

Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified. In an exploratory study, we assessed the relationship between organisational culture in primary care centres as perceived by primary care teams and patient-perceived levels of integrated care

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.

Supporting integrated care in practice: Perceptions of a national support programme for the development of New Care Models in England

This paper investigates the perceptions of key informants on a national support programme for the development of New Care Models in England (2015/16 to 2017/18). It focuses on the perceived facilitators and barriers affecting the development and implementation of the New Care Models programme and offers some insight into the role of national level support in enabling local integration initiatives. Besides the paper demonstrates that analysis of facilitators and challenges with respect to the national support of implementation of integrated care initiatives should move beyond the focus on separate influencing factors and address the tensions that the complex ...

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.