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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.

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.

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.

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.

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.

The paper is confined to experience in Scotland.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The organisation of health and social care in Devon including Torbay and Plymouth has developed over the last few years into different organisational structures. This paper aims to compare these different models.

Routine information and audit data were analysed to explore what was known about the different organisational models in health and social care in Devon.

There is evidence from these data that more highly integrated models of care have demonstrable benefits for users and for local health and social care economies.

The local organisational models are complex and it is not known whether they are transferable to other settings. The data used in the study are routine data, and therefore, may include confounding factors; the local audit data may be subject to observer error. More research is recommended in this area.

As health and social care services move towards greater integration and the health care market creates different combinations of provider integration, this paper discusses what routine data can tell us about these models of care and what the implications are for both commissioners and providers of health and social care in the future.

Benefits of health and social care integration are often described by case study and this review using quantitative data adds to the evidence base supporting integration as a way forward.