Centre for Health Economics, University of York, York, UK
There is an increasing policy emphasis on the integration of care, both within the healthcare sector and also between the health and social care sectors, with the simple aim of ensuring that individuals get the right care, in the right place, at the right time. However, implementing this simple aim is rather more complex. In this editorial, we seek to make sense of this complexity and ask: what does integrated care mean in practice? What are the mechanisms by which it is expected to achieve its aim? And what is the nature of the evidence base around the outcomes delivered?
Kodner D. All together now: a conceptual exploration of integrated care. Healthcare Q. 2009; 2009;13 Spec No:6-15. doi:10.12927/hcq.2009.21091
Goodwin N, Smith J, Davies A, et al. A Report to the Department of Health and the NHS Future Forum – Integrated care for patients and populations: Improving outcomes by working together. London: The King’s Fund and Nuffield Trust; 2012.
Lê G, Morgan R, Bestall J, Featherstone, Veale T, Ensor T. Can service integration work for universal health coverage? Evidence from around the globe. Health Policy. 2016;120(4):406-419. doi:10.1016/j.healthpol.2016.02.007
Kodner DL, Spreeuwenberg C. Integrated care: meaning, logic, application, and implications – a discussion paper. Int J Integr Care. 2002;2:e12. doi:10.5334/ijic.67
National Collaboration for Integrated Care and Support. Integrated care and Support: our shared commitment. London: Department of Health; 2013.
Ham C, Curry N. Integrated care – What is it? Does it work? What does it mean for the NHS? London: The King’s Fund; 2011.
Nolte E, Pitchforth E. What is the evidence on the economic impacts of integrated care?Policy Summary 11. Copenhagen: World Health Organisation; 2014.
Ham C, Curry N. Clinical and service integration: the route to improved outcomes. London: The King’s Fund; 2010.
Mason A, Goddard M, Weatherly H. Financial mechanisms for integrating funds for health and social care: an evidence review. CHE Research Paper No. 97. York: University of York, Centre for Health Economics; 2014.
Cameron A, Lart, R, Bostock L, Coomber C. Factors that promote and hinder joint and integrated working between health and social care services. Research Briefing 41. London: Social Institute for Excellence; 2012.
Mason A, Goddard M, Weatherly H, Chalkley M. Integrating funds for health and social care: an evidence review. J Health Serv Res Policy. 2015;20(3):177-188. doi:10.1177/1355819614566832
Audit Commission. Means to an end: Joint financing across health and social care. London: Audit Commission; 2009.
Department of Health, Department for Communities and Local Government. Better Care Fund, Policy Framework 2016/17. London: Department of Health; 2016.
NHS England. People helping people. Year two of the pioneer programme. London: NHS England Publication Gateway Ref 04386; 2016.
NHS England. New care models: Vanguards – developing a blueprint for the future of NHS and care services. London: NHS England; 2016.
Ham C, Alderwick H. Place-based systems of care: A way forward for the NHS in England. London: The King’s Fund 2015.
Ramsay A, Fulop N, Edwards N. The evidence base for vertical integration in health care. J Integr Care. 2009;17(2):3-12. doi:10.1108/14769018200900009
Shortell, S. The NHS five year forward view: lessons from the United States in developing new care models. BMJ. 2015; 350:h2005. doi:10.1136/bmj.h2005
Erens B, Wistow G, Mounier-Jack S, et al. Early evaluation of the Integrated Care and Support Pioneers Programme. Policy Innovation Research Unit (PIRU); 2016-2017.
Segal L, Dunt D, Day SE. Introducing coordinated care (2): evaluation of design features and implementation processes implications for a preferred health system reform model. Health Policy.2004;69(2):215-228. doi:10.1016/j.healthpol.2004.02.001
Singer S, Burgers J, Friedberg M, Rosenthal MB, Leape L, Schneider E. Defining and measuring integrated patient care: promoting the next frontier in health care delivery. Med Care Res Rev. 2011;68(1):112-127. doi:10.1177/1077558710371485
Bardsley M, Steventon A, Smith J, Dixon J. Evaluating integrated and community-based care – How do we know what works? Research summary. London: Nuffield Trust; 2013.
Dickinson H. Making a reality of integration: less science, more craft and graft. J Integr Care. 2014;22(5/6):189-196. doi:10.1108/JICA-08-2014-0033