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Early findings from the evaluation of the Integrated Care and Support Pioneers in England

Bob Erens (Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK)
Gerald Wistow (PSSRU, Social Policy, London School of Economics and Political Science, London, UK)
Sandra Mounier-Jack (London School of Hygiene and Tropical Medicine, London, UK)
Nick Douglas (London School of Hygiene and Tropical Medicine, London, UK)
Tommaso Manacorda (London School of Hygiene and Tropical Medicine, London, UK)
Mary Alison Durand (London School of Hygiene and Tropical Medicine, London, UK)
Nicholas Mays (London School of Hygiene and Tropical Medicine, London, UK)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 3 July 2017

Abstract

Purpose

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.

Design/methodology/approach

Mixed methods involving documentary analysis, qualitative interviews and an online key informant survey.

Findings

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.

Research limitations/implications

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.

Practical implications

The persistence of many barriers to integration highlights the need for greater national support to remove them.

Originality/value

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.

Keywords

Acknowledgements

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.

Citation

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

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited