People powered primary care: learning from Halton

A community-centred approach to health called Community Wellbeing Practices (CWP) is being to patients at all 17 GP Practices in Halton in order to respond more appropriately to patients´social needs which are often an underlying reason for their presentation at primary care services. 

Early findings from the evaluation of the integrated care and support pioneers in England

Integrating health and social care is priority in England, although there is little evidence that previous iniciatives have reduce hospitals admissions or costs. Twenty-five Integrated Care Pioneers have been established to drive change "at scale and place". The early phases of their evaluation (April 2014-June 2016) aimed to identify their objetives, plans ans activities, and to assess the extend to which they have overcome barriers to integration. In the longer-term, we will assess whether integrated care leads to improved outcomes and quality of care and at what cost. 

A systematic review of strategies to increase access to health services among children in low and middle income countries

Universal Health Coverage is widely endorsed as the pivotal goal in global health, however substantial barriers to accessing health services for children in low and middle-income countries exist. Failure to access healthcare is an important contributor to child mortality in these settings. Demand side interventions included: educational programmes, text messages, and financial or other incentives. Interventions that delivered services at or closer to home and text messages were in general associated with a significant improvement in relevant outcomes.

There are some intervention areas that seem to show encouraging trends including text message reminders and delivery of services at or close ...

Experiencing integration: a qualitative pilot study of consumer and provider experiences of integrated primary health care in Australia

The terms integration and integrated care describe the complex, patient-centred strategies to improve coordination of healthcare services. Frameworks exist to conceptualise these terms, but these have been developed from a professional viewpoint. 

The objetive of this study was to explore consumers and provider´s concepts, expectations and experience of integrated care. A key focus was whether frameworks developed from a professional perspective are effective models to explore people´s experiences. 

Bringing integration home: policy on health and social care integration in the four nations of the UK

This paper outlines relevant policies on the integration of health and social care in four home nations: Scotland, Wales, Northern Ireland and England. The aim of the paper is to offer a comparison of emphasis and approaches and draw out general insights on the implementation of integrated care policy. Also in this paper reveals considerable opportunities for further research and comparative modelling of integration approaches. 

Integrating safety concepts in health and social care

Keeping individuals safe from harm and exploitation is a clearly articulated goal within both the health and social care sectors. Two key concepts associated with achieving this common aim are safety and safeguarding. The purpose of this paper is to critically appraise the differences in safety terminology used in health and social care, including opportunities and challenges for greater integration of safety systems across health and social care in England. 

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic  diseases. International evidence suggest that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA. 

The role of organizational structure in readiness for change: A conceptual integration

The purpose of this review is to extend extant conceptualizations of readiness for change as an individual-level phenomenon. This review-of-reviews focuses on existing conceptual frameworks from the dissemination, implementation, quality improvement, and organizational trasformation literatures in order to integrate theoretical rationales for how organization structure, a key dimension of the organizational context, may impact readiness for change. They propose that the organization structure dimensions of differentiation and integration impact readiness for change at the indicidual level of analysis by influencing four key concepts of relevance, legitimacy, preceived need for change, and resource allocation. 

Understanding and Evaluating the Implementation on Integrated Care: A "Three Pipe Problem"

Altought we have come a long way in being able to articulate the key building blocks of integrated care, the interplay between them is so complex and interwined that it seems an impossible challenge to create any simple implementation model. Yet, if integrated care is to advance, we must become better at smoothing over the many obstacles and challenges to implementation that have bedevilled the uptake and roll-out of even the most proven of integrated care interventions.

This is quite the "three-pipe problem" for integrated care since science has yet to make the real breakthrough to address how we might ...

The theory and practice of integrative health care governance: the case of New Zealand´s alliances

The purpose of this paper is to outline the theory and practice of governance for integrated care, using the case of New Zealand´s healthcare alliances.

This paper argued that the new "experimental" governance models are needed for effective development of integrated care, illustrated through the example of alliance governance in New Zealand. While the alliances are in a relatively incipient state, they hold considerable promise when compared with the alternatives: corporate, democratic or clinical governance. Alliance governance provides for a different way of working, and for boldstering clinical leadership as central to this.