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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.

The purpose of this paper is to detail the research and findings from a piece of work commissioned by the Local Government Association in England, in May 2013 into the current implementation of integrated care.

The field research was carried out by Integrating Care, a collaborative drawn from leading academics, health and social care executives, analysts and clinicians working in the field of integrated care; along with consultancy support from public sector consultancies PPL and GE Healthcare Finnamore. It comprised a series of local interviews, workshops, modelling and analysis and ongoing engagement.

The paper describes the outputs that were delivered to support the development of “whole-system” integrated health and social care drawing on national and international best-practice, and knowledge gained from experiences of implementation.

The paper concludes by drawing together the key lessons from the overarching analysis of whole-system integration. This includes the opportunities and the complexities of redesigning and re-implementing better co-ordinated health and social care provision at scale, as experienced in England currently.

The paper describes the specific challenges posed through the fieldwork and ongoing development process of integration in England, and the paper reflects upon some of the deeper questions that this has led to. The paper then draws together the research and analysis with emerging, strategic questions around the concept of value in health provision; and begins to question whether this has yet been demonstrated; and, if not, what a demonstration and evidencing of “value” in this context might look like.

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 presents a comparison of the views of staff working in 18 integrated care settings, undertaken as part of the PROCARE study of integrated health and social care. The data reveals some apparent commonalities across the nine European countries. Increased job satisfaction was an advantage of integrated working, but respondents also reported difficulties in working with hospitals or medical professionals, and continued barriers to integrated working generally. Overall, single standalone organisations such as home care teams reported the clearest benefits from integrated working, while cross‐agency models continued to encounter significant barriers to health and social care integration.

This article's aim is to consider the implications for integrated care in England of the “community right to challenge” provisions of the Localism Act 2011.

The article's approach is an analysis of the Localism Act 2011, secondary legislation made under that Act and a review of the existing literature on the Localism Act 2011.

The Localism Act 2011 community right to challenge provisions have the potential to lead to innovative ways of providing services but they also have the potential to undermine or inhibit integrated care arrangements.

The article analyses the provisions of the Localism Act 2011 together with the provisions of secondary legislation which provide for its detailed operation.

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.

The authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.

The IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.

This study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.

It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper examines qualitative data from PROCARE, a recently completed European project on integrated care for older people, to put forward an interpretation of what integrated care means to staff. Through thematic analysis, four main clusters were identified. The paper suggests that, while the analysis revealed a common and inter‐related European interpretation that was somewhat idealised and moralistic, this was countered by challenges to its implementation that were inseparable from the rhetoric. The paper suggests that a collective, morally strong understanding is unable to prevent barriers to integrated care, and that tensions between services remain a prominent impediment.

The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries.

The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people.

The author’s premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems.

This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept.

Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing a growing number of problems and challenges. Being able to inquire on significant challenges in health and social care through a spatial lens has the potential to provide another, highly practical, kind of evidence in this field of work. This lens is, the author contends, very poorly integrated into either health or social care at present. However, doing so would have a variety of useful outcomes for monitoring and intervening on real problems in care integration. An example could be “frequent flyers” in emergency departments as has been done in Camden, New Jersey through patient mapping.

The author’s position in this paper is that the challenges we face in providing integrated care to ageing and increasingly disabled (including both physical and cognitive impairments) populations will only grow in the face of variable governmental responses and increasingly complex funding and service provider arrangements. Without a geographical perspective and the concepts and tools of spatial science the author does not see an adequate response emerging. The shift to community-based care for many groups, including the aged, means that location will become more important rather than less so. This is a societal concern of major proportions and the very concept of integrated care requires of us a geographical perspective.

This is a short but, the author believes, conceptually rich piece with a variety of potential practical implications for health and social care service provision. Issues of equity, quality, safety and even basic access can only grow as population ageing progresses and various forms of chronic disease and disability continue to grow. Knowing where the most affected people and their social and service connections are located will support better integration. And better integration may resolve some of the financial and related resource problems that are already evident but which can only continue to increase. In this context, the author suggests that the integrated care of the future needs to be geographically informed to be effective.

The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.

This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.

Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.

The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.

It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.

Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.

The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.

The purpose of this paper is to share the challenges of, and learning gained by a voluntary sector organisation, Coventry Rape and Sexual Abuse Centre (CRASAC) in providing integrated care to victims of sexual violence.

The paper first considers the big picture, focusing on the current UK public sector commissioning environment, the policy commitment to integrated care, and challenges a current focus on definitions of integration that do not consider wider determinants of health and well-being. As an example of client groups who may not meet narrow criteria, but require person centred coordinated care, the needs of victims of sexual violence are explored, illustrated by a case study within CRASAC.

Challenges faced by CRASAC include identifying responsibility for specialist commissioning, maintaining strategic partnerships and a lack of cross-sector understanding of the needs of victims of sexual violence. Key learning points are the need to form strategic alliances and partnerships, to lobby and influence decision makers, to develop monitoring tools that demonstrate impact on long-term client outcomes and to constantly raise awareness of the needs of victims of sexual violence. Final reflections focus on the questions these issues raise for the future of specialised integrated care in the voluntary sector.

The paper is of value to commissioners in health, social care and the criminal justice system, in addition to providers of services that are in contact with victims of sexual abuse. These include health, criminal justice, education, police and social care, alongside other voluntary and community sector organisations.