Integrated care: easy in theory, harder in practice?

Integrated care (IC) is a term now commonly adopted across the world, which implies a positive attitude towards addressing fragmentation of service provision inside health systems. While the principles of IC are simple, their implementation is more controversial. The ever growing number of IC definitions is related to the increasing domains of applications, which reflect the increasing demand induced by ageing multi-morbid patients. An exhaustive definition of IC should now enclose the coordination of health and social services useful to deliver seamless care across organizational boundaries. The current debate on IC is largely fueled by the modern mismatch between the ...

Integrated Care in Europe: Time to Get it Together?

What are the priorities for the future development of integrated care? A scoping review

“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue.

Reform For People: A Joint Vision For Integrating Care

Many of us will be watching closely as the NHS Bill begins its journey through Parliament and will be seeking to ensure that it meets the needs of the people we support. However, while the Bill represents an exciting opportunity, previous NHS reforms have taught us that legislation alone is not enough to improve people’s health and lives. For these reforms to be a success, and make a real difference to people and communities, we need to go further. We need to improve cultures, change behaviours, and capture hearts and minds.

National Voices, Age UK, the Richmond Group of ...

Measuring Older Peoples’ Experiences of Person-Centred Coordinated Care: Experience and Methodological Reflections from Applying a Patient Reported Experience Measure in SUSTAIN

While several evaluation studies on (cost-)effectiveness of integrated care have been conducted in recent years, more insight is deemed necessary into integrated care from the perspective of service users.

In the context of a European project on integrated care for older people living at home (SUSTAIN), this paper shares the experience and methodological reflections from applying a Patient Reported Experience Measure (PREM) on person-centred coordinated care -the P3CEQ- among this population.

A Cross-European Study of Informal Carers’ Needs in the Context of Caring for Older People, and their Experiences with Professionals Working in Integrated Care Settings

Informal carers are increasingly relied on for support by older people and the health and social care systems that serve them. It is therefore important that health and social care professionals are knowledgeable about and responsive to informal carers’ needs.

This study explores informal carers’ own needs within the context of caregiving; and examines, from the informal carers’ perspective, the extent to which professionals assess, understand and are responsive to informal carers’ needs.

The Contribution of Case Mix, Skill Mix and Care Processes to the Outcomes of Community Hospitals: A Population-Based Observational Study

Community hospitals could address the emerging complex care needs of patients. The authors investigated which characteristics of patients and community hospitals affect patient outcomes, in order to identify who could benefit the most from community hospital care and the best skill mix to deliver this care.

Applying Complexity Theory to a Hospital Complex Patient Care Program

Increasingly, complexity science concepts are informing health care design and practice. The present paper describes the implementation of early complexity science principles in a Complex Care Program with the aim of strengthening the provision of integrated care. Grounded in cybernetic network theory, Stafford Beer’s Viable Systems Model provided the guiding principles for the program’s redesign. The Viable Systems Model with its broadly applicable principles, is now the conceptual model of information management in the program. Beer’s framework has enabled a relatively small number of clinicians to coordinate care for a large cohort of patients with significant clinical ...

Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis

Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC).

Integrated care systems are an opportunity to reset the relationship between health services and the public

‘The more we concentrate on merely reworking our existing institutions, the more we fail to see or understand the nature of the new challenges that surround us.’
Hilary Cottam, Radical help