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Article
Publication date: 1 April 2007

Jenny Robb and Peter Gilbert

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that…

Abstract

Integration is a watchword in Government policy, designed to give more seamless, and therefore more effective, services to people in need. One concern, though, is that this is merely a ‘structural’ approach that just rearranges the deckchairs. This paper gives a practical example of a positive, local leadership approach to integration within a national context.

Details

International Journal of Leadership in Public Services, vol. 3 no. 1
Type: Research Article
ISSN: 1747-9886

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Article
Publication date: 1 December 2005

Steve Iliffe, Kalpa Kharicha, Claire Goodman, Cameron Swift, Danielle Harari and Jill Manthorpe

Successive policy documents concerning older people's health and well‐being have aimed to improve their care, by raising standards and promoting independence. These…

Abstract

Successive policy documents concerning older people's health and well‐being have aimed to improve their care, by raising standards and promoting independence. These policies also emphasise the need for research to prevent disability, and reduce admission to hospitals and long‐term care settings. This paper reports an evaluation in progress of a health technology approach designed to achieve these objectives. An ‘expert system’ is described that is intended to improve older people's access to health and social care information, to enable service providers to review the health and social care needs of older people, and to allow planners to assess the needs of whole populations. The paper ends by inviting discussion and responses from readers of this journal.

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Quality in Ageing and Older Adults, vol. 6 no. 4
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 16 February 2015

Alison Taylor

In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is…

Abstract

Purpose

In this paper, the Scottish Government's approach to improving outcomes for patients and service users by integrating health and social care planning and provision is described. The Scottish Parliament passed primary legislation in February 2014, which places requirements on Health Boards and Local Authorities to work together more closely than ever before. The paper aims to discuss these issues.

Design/methodology/approach

This paper sets out the Scottish Government's legislative approach to integrating health and social care, based on previous experience of encouraging better partnership between health and social care working without legislative compulsion.

Findings

The Scottish Government has concluded that legislation is required to create the integrated environment necessary for health and social care provision to meet the changing needs of Scotland's ageing population.

Research limitations/implications

The paper is confined to experience in Scotland.

Practical implications

Legislation is now complete, and implementation of the new arrangements is starting. Evaluation of their impact will be ongoing.

Social implications

The new integrated arrangements in Scotland are intended to achieve a significant shift in the balance of care in favour of community-based support rather than institutional care in hospitals and care homes. Its social implications will be to support greater wellbeing, particularly for people with multimorbidities within communities.

Originality/value

Scotland is taking a unique approach to integrating health and social care, focusing on legislative duties on Health Boards and Local Authorities to work together, rather than focusing on structural change alone. The scale of planned integration is also significant, with planning for, at least, all of adult social care and primary health care, and a proportion of acute hospital care, included in the new integrated arrangements.

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Article
Publication date: 1 October 2008

Sue Adams

Older people (particularly 75 years+) are the main users of health and social care services. They are also the age group most likely to occupy non‐decent homes. Government…

Abstract

Older people (particularly 75 years+) are the main users of health and social care services. They are also the age group most likely to occupy non‐decent homes. Government health and social care policy is increasingly focused on enabling more older people to remain living independently in their own homes and on delivery of care ‘at or closer to home’. This article considers how greater recognition of the negative impacts of poor‐quality and inappropriate housing on older people's health and well‐being, combined with targeted housing repair and adaptation assistance, could contribute to achieving a range of current health and social care objectives, including enabling older people to live independently in mainstream housing and better management of chronic health conditions.

Details

Journal of Integrated Care, vol. 16 no. 5
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 1 February 2004

Ray Jones

The paper charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights two important messages for others at different…

Abstract

The paper charts ten years of movement in Wiltshire towards greater integration for health and social care, and highlights two important messages for others at different stages of the process. The first is that while an early strategic vision can create the right conditions, there can be no short cuts to effective integration. The second is that independent evaluation is necessary to produce the evidence to sustain initiatives and promote organisational and professional learning ‐ which are key ingredients of the change process.

Details

Journal of Integrated Care, vol. 12 no. 1
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 28 November 2012

Don Brand

This article begins a series of three about making a reality of integration policy in health and social care at individual, functional and cultural levels.

Abstract

Purpose

This article begins a series of three about making a reality of integration policy in health and social care at individual, functional and cultural levels.

Design/methodology/approach

The paper outlines messages from policy debate and the Adult Social Care White Paper about the benefits to individuals and carers of improvements in integration. It follows the progress of a 91‐year‐old widow during a recent six‐week stay in hospital, and the difficulties she and her daughter encountered through professional and service faultlines and information blocks.

Findings

The paper questions the White Paper proposal for named professionals to coordinate care for people with complex needs, and argues that the benefits of integration will not be achieved without a significant change of culture. It outlines later papers exploring a functional model of integration, and examining the implications of culture change for the relationships between health and social care, between professionals and individuals, and between the Department of Health and the health and care system.

Originality/value

In “placing the individual at the centre”, the article grounds a series linking the newly‐published Care and Support White Paper and the emerging NHS reform programme to examine changes needed if integration is to benefit individuals and carers.

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Article
Publication date: 1 February 2004

J. Billings, A. Alaszewski and K. Coxon

This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses…

Abstract

This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the structural complexities that create the challenges in integrated care, compares and contrasts approaches to integrated care through a structure and process framework, and considers the place of person‐centred seamless care in European health and social care models.

Details

Journal of Integrated Care, vol. 12 no. 1
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 28 November 2012

Derek Birrell and Deirdre Heenan

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context…

Abstract

Purpose

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context of the existing integrated structures. It is designed to promote a better understanding of the implications of the proposed reconfiguration of health and social care.

Design/methodology/approach

This paper reviews a number of published documents encompassing an independent review and subsequent plans and strategies. It also draws upon a case study of a Rapid Access Clinic undertaken by the authors as part of a wider research project.

Findings

The paper concludes that the planned changes question the ability of an integrated structure operating across primary, secondary and social care. It notes that there are real concerns about the capacity of the social care workforce to deliver services. It is suggested that the proposal for Integrated Care Partnerships can be seen as a reflection of the need for a more localised approach to delivery.

Research limitations/implications

The findings are derived from a small‐scale study and as such may make generalisation difficult. There is a clear need for a more robust evidence‐based approach to the evaluation of structural integration in health and social care and a process for monitoring of this change process.

Originality/value

The article is a reminder of the unique example of structural integration within the UK. As such it could have important lessons for England, Scotland and Wales which are moving in a similar direction.

Details

Journal of Integrated Care, vol. 20 no. 6
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 1 December 1999

C. Vellenoweth

The Government has published proposals to set up two new structures ‐ one for the regulation of social services and one for independently provided health care. This…

Abstract

The Government has published proposals to set up two new structures ‐ one for the regulation of social services and one for independently provided health care. This article argues that a single regulator for all categories of health care, including that provided in social care settings, would be more cost‐effective. It proposes the creation of functionally ring‐fenced divisions of health care regulation, structured within and answerable to the proposed commissions for care standards.

Details

Journal of Integrated Care, vol. 7 no. 6
Type: Research Article
ISSN: 1476-9018

Content available
Book part
Publication date: 6 May 2019

Denise Alexander, Uttara Kurup, Arjun Menon, Michael Mahgerefteh, Austin Warters, Michael Rigby and Mitch Blair

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental…

Abstract

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

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