National Framework for Children and Young People’s Continuing Care

This Framework (reviewed) is intended to provide guidance for clinical commissioning groups (CCGs) when assessing the needs of children and young people whose complex needs cannot be met by universal or specialist health services. CCGs have a legal responsibility for securing to a reasonable extent the health care which an individual needs, and this guidance is about the process which should be followed for the equitable discharge of that responsibility for children and young people with complex needs. This revision takes account of the new structures of NHS commissioning created by the Health and Social Care Act 2012 and the new integrated approach to the commissioning of services for children and young people with special educational need or disability (SEND) which the Children and Families Act 2014 introduced. In particular, where a child or young person has a SEND, which will often be the case, then CCGs and local authorities ...

Primary care managers´perceptions of their capability in providing care planning with complex needs

The aim of this study is to investigate primary care managers´perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient´s care needs and plan care interventions together. 

Meet Integrated Care Pioneers in Edinburgh, Manchester and Wrexham!

Study tours offer a unique opportunity to meet integrated care pioneers in their natural environment and to experience and learn about integrated care practices from national and regional innovations. They are designed to support clinicians, managers and policy-makers with an interest and responsibility in the successful adoption of integrated care in policy and practice. Designed to be live case studies, the study visits offer the possibility to discuss regional and country-level strategies with the responsible decision makers, assess the barriers, facilitators and key drivers for integrated care at a regional and local level and reflect upon the transferability of lessons learned in moderated discussions and workshops.

The ICIC17 Three Country Study Tour will visit Scotland, England and Wales and seeks to examine the leadership and management of integrated care in these regions. Sessions will focus on the development of new models and approaches to care for older people with complex ...

WHO launches an innovative package of tools to support person-centred and integrated care for older people

On the International Day of the Older Person (1st October) the World Health Organization (WHO) released a package of tools to support the implementation of the Integrated Care for Older People (ICOPE) approach.

ICOPE, based on the WHO Framework on integrated people-centred health services, has been developed in the context of populations around the world ageing rapidly. It enables health and long-term care systems-and the services within them-to respond optimally to the unique, varied and often complex needs of older people.

The package of tools includes: the ICOPE Implementation Framework (guidance for policy makers and programme managers to assess and measure the capacity of services and systems to deliver integrated care at the community level); the ICOPE Handbook, which describes practical care pathways to detect declines in intrinsic capacity and develop personalised care plans; and the ICOPE handbook App, which helps implement ICOPE in community care settings.

Access ICOPE tools ...

Should community pharmacy be 'linked'? The perceptions of including community pharmacy in an integrated care model in Ontario, Canada

Integrated care models are becoming more frequent in various health systems to provide quality coordinated care, with the aim of improving patient outcomes and costs. Many patients under an integrated care model present with complex health and social needs requiring more sophisticated care coordination. 

Mapping Evidence of Patients’ Experiences in Integrated Care Settings: A Protocol for a Scoping Review

Integrated care (IC) models have emerged to address gaps in care for individuals with complex healthcare needs. Although the clinical and cost-effectiveness of IC models are well-established, the understanding of whether IC models facilitate a patient-centred care experience from the patients’ perspective is not well understood. This scoping review aims to comprehensively map the literature to provide a broad overview of patients’ experiences in IC settings with a focus on the experiences of complex patients with comorbid mental and physical illnesses. It also aims to describe current gaps identified in the literature in our understanding of aspects of care that are often unrecognised.

From Crisis to Coordination: Challenges and Opportunities for Integrated Care posed by the COVID-19 Pandemic

The pandemic caused by Covid 19 affects all types of countries and societies without distinction. However, within the com link, the unit shows brutal inequality in its "attack."The impact of COVID-19 has thrown into sharp relief the problems that fragmented health and care systems face in adapting to crises that require an urgent and collaborative response. The disproportionate impact of the pandemic – for example on ethnic minority and indigenous populations; on older people living in residential aged care facilities; on those living in rural and remote communities; on the poorest; and on people with the most complex health and care needs – says much about our continued inability to coordinate care and support our vulnerable communities, and so expose them to disproportionate risk.

This editorial does not propose 3 action challenges:

Challenge 1: Responses to COVID-19 have largely NOT been integrated, leading to adverse outcome

Challenge 2: Responses continue to ...

A journey towards integrated person-centred care: a case study of a mental health perspective in the voluntary sector

Models of integrated care for older people with frailty: a horizon scanning review

Frailty, a multifaceted geriatric condition, is an emerging global health problem. Integrated care models designed to meet the complex needs of the older people with frailty are required. Early identification of innovative models may inform policymakers and other stakeholders of service delivery alternatives they can introduce and locally adapt so as to tackle system fragmentation and lack of coordination. This study used horizon scanning methodologies to systematically search for, prioritise and assess new integrated care models for older people with frailty and investigated experts’ views on barriers and facilitators to the adoption of horizon scanning in health services research.

International comparisons of the quality and outcomes of integrated care: Findings of the OECD pilot on stroke and chronic heart failure

Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new generation of indicators to support international benchmarking of quality of integrated care. Lessons from the pilot call for further work on:

(1) expanding work on indicator development;

(2) performing policy analysis to understand cross-country variations on governance models and health financing;

(3) upscaling data linkage; and

(4) measuring care fragmentation.

Nursing Care Coordination in Primary Healthcare for Patients with Complex Needs: A Comparative Case Study

Despite nurses’ substantial role in care coordination, few education programs exist to better support them in this role. Identification of a set of core care coordination activities across heterogeneous care coordination programs would facilitate the development of a standard of practice. We sought to examine care coordination activities across two care coordination programs in Family Medicine Groups in Quebec, and their relationship to the program design.

Integrating Health and Care for Older People in China: What Has Been Accomplished? What is Next?

In China, in addition to its rapid ageing process and large older population, the incidence of chronic disease and disability in the elderly is astonishingly high. Among the 267 million people aged 60 and over in 2021, there were about 190 million people with at least one chronic disease and 40 million living with disability [1]. This has created a huge challenge for the world’s most populous country which is also a middle-income economy in caring for its senior citizens. In response to the complex needs of the elderly and drawing from international experience, China has adopted an active ageing and healthy ageing strategy, and integrating health and care has increasingly been a policy priority for coping with population ageing in the past decade. Progress has been made while challenges remain. The experiences and lessons of China might be referential for the other middle income countries in integrating health ...