Integrating health and social care is a priority in England, although there is little evidence that previous initiatives have reduced hospital admissions or costs. In total, 25 Integrated Care Pioneers have been established to drive change “at scale and pace”. The early phases of the evaluation (April 2014-June 2016) aimed to identify their objectives, plans and activities, and to assess the extent to which they have overcome barriers to integration. In the longer term, the authors will assess whether integrated care leads to improved outcomes and quality of care and at what cost. The paper aims to discuss these issues.
Mixed methods involving documentary analysis, qualitative interviews and an online key informant survey.
Over time, there was a narrowing of the integration agenda in most Pioneers. The predominant approach was to establish community-based multi-disciplinary teams focussed on (older) people with multiple long-term conditions with extensive needs. Moving from design to delivery proved difficult, as many barriers are outside the control of local actors. There was limited evidence of service change.
Because the findings relate to the early stage of the 5+ years of the Pioneer programme (2014-2019), it is not yet possible to detect changes in services or in user experiences and outcomes.
The persistence of many barriers to integration highlights the need for greater national support to remove them.
The evaluation demonstrates that implementing integrated health and social care is not a short-term process and cannot be achieved without national support in tackling persistent barriers.
The authors would like to thank the members of staff in all the Pioneer sites who kindly agreed to be interviewed and to complete the online survey. The authors would also like to thank the members of the patient and public involvement (PPI) Steering Group, who provided many helpful comments on documents and reports that formed part of the early evaluation. This work is an independent evaluation commissioned and funded by the Department of Health’s Policy Research Programme. The views expressed are not necessarily those of the Department or its partners.
Erens, B., Wistow, G., Mounier-Jack, S., Douglas, N., Manacorda, T., Durand, M.A. and Mays, N. (2017), "Early findings from the evaluation of the Integrated Care and Support Pioneers in England", Journal of Integrated Care, Vol. 25 No. 3, pp. 137-149. https://doi.org/10.1108/JICA-12-2016-0047
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