(Dis)Integrated Care? Lessons from East London

This paper examines one of the NHS England Pioneers programmes of Integrated Care, which was implemented in three localities in East London, covering the area served by one of the largest hospital groups in the UK and bringing together commissioners, providers and local authorities. The partners agreed to build a model of integrated care that focused on the whole person.

This qualitative and participatory evaluation looked at how an ambitious vision translated into the delivery of integrated care on the ground. The study explored the micro-mechanisms of integrated care relationships based on the experience of health and social care professionals ...

Integrated health and care systems in England: can they help prevent disease?

The National Health Service (NHS) in England plans for the entire country to be covered by integrated care systems (ICSs) by April 2021. The aims of these local health and care partnerships are broad and include improving disease prevention and population health while maintaining NHS financial sustainability. Yet, the evidence for more integrated care leading to better disease prevention is weak.

Although nearly all of the 2016 sustainability and transformation partnership (STP) plans included a prevention or population health strategy, the content varied widely, often lacked detail, and had little on population-level interventions affecting the social determinants of health.

The ...

Exploring the Team Climate of Health and Social Care Professionals Implementing Integrated Care for Older People in Europe

Team climate describes shared perceptions of organisational policies, practices and procedures. A positive team climate has been linked to better interprofessional collaboration and quality of care. Most studies examine team climate within health or social care organisations. This study uniquely explores the team climate of integrated health and social care teams implementing integrated care initiatives for older people in thirteen sites across seven European countries, and examines the factors which contribute to the development of team climate.

Can Integrated Care Help in Meeting the Challenges Posed on Our Health Care Systems by COVID-19? Some Preliminary Lessons Learned from the European VIGOUR Project

The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOUR (“Evidence based Guidance to Scale-up Integrated Care in Europe”).

Supporting Older People to Live Safely at Home – Findings from Thirteen Case Studies on Integrated Care Across Europe

While many different factors can undermine older people’s ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. Integrated care services across Europe address older people’s safety in many ways. Further integration of health and social care solutions is necessary to enhance older people’s perceptions of safety.

Patient autonomy in the consultation: How signalling structure can facilitate patient-centred care

This paper explores how patient autonomy may be supported or undermined in doctor-patient interactions through sharing information about what is to happen in the consultation. Doctors use a variety of verbal signalling behaviours with multiple functions. As well as sharing information, these behaviours regulate patient agency in the consultation.

The clinical effectiveness of the COPDnet integrated care model

COPD is a disease with a high prevalence in the world. Despite the great personal and family involvement, it has been seen that integrated care between hospitals and primary care translates into better clinical results for patients. Integrated care models have the potential to improve outcomes for patients with COPD. The research team design the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.

Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis

Integrated care is said to improve the way in which care is delivered. To support integrated care by ensuring close collaboration between involved stakeholders, information and communication technologies, especially telemedicine, are needed. Despite their potential, most telemedicine solutions never make it from pilot project stage to full implementation into usual care. Especially in integrated care scenarios, understanding of the barriers hampering successful telemedicine implementation and application is limited.

Integrated and patient-centred management of Parkinson’s disease: a network model for reshaping chronic neurological care

Chronic neurological diseases are the leading cause of disability globally. Yet, our health-care systems are not designed to meet the needs of many patients with chronic neurological conditions. Care is fragmented with poor interdisciplinary collaboration and lack of timely access to services and therapies. Furthermore, care is typically reactive, and complex problems are managed inadequately because of a scarcity of disease-specific expertise and insufficient use of nonpharmacological interventions. Treatment plans tend to focus on the disease rather than the individual living with it, and patients are often not involved in clinical decision making. By use of Parkinson’s disease as ...

Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium

The twelve Integrated Care Program pilot projects (ICPs) created by the government plan ‘Integrated Care for Better Health’ aim to achieve four outcome types (the Quadruple Aim) for people with chronic diseases in Belgium: improved population health, improved patient and provider experiences and improved cost efficiency. The Belgian plan is based on the model of integrated care by the World Health Organization. The objective of this study is to deliver policy recommendations on strategies and best practices to improve care integration in Belgium and to implement a sustainable monitoring system that serves both policy makers and the stakeholders within the ...