More that unites us than divides us? A qualitative study of integration of community health and social care services
Abstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integrati...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12875-020-01168-z |
| _version_ | 1818111902815879168 |
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| author | Claire Mitchell Abigail Tazzyman Susan J. Howard Damian Hodgson |
| author_facet | Claire Mitchell Abigail Tazzyman Susan J. Howard Damian Hodgson |
| author_sort | Claire Mitchell |
| collection | DOAJ |
| description | Abstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of 12 integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation. Methods Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city. |
| first_indexed | 2024-12-11T03:10:26Z |
| format | Article |
| id | doaj.art-e5cf0d748d464e3a8447cd7c7a10e8bf |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-11T03:10:26Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-e5cf0d748d464e3a8447cd7c7a10e8bf2022-12-22T01:22:52ZengBMCBMC Family Practice1471-22962020-05-0121111010.1186/s12875-020-01168-zMore that unites us than divides us? A qualitative study of integration of community health and social care servicesClaire Mitchell0Abigail Tazzyman1Susan J. Howard2Damian Hodgson3Alliance Manchester Business School, University of Manchester and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater ManchesterAlliance Manchester Business School, University of Manchester and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater ManchesterSalford Royal NHS Foundation Trust, University of Manchester and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater ManchesterAlliance Manchester Business School, University of Manchester and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater ManchesterAbstract Background The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of 12 integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation. Methods Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.http://link.springer.com/article/10.1186/s12875-020-01168-zIntegrationCommunity servicesHealth careSocial careQualitative research |
| spellingShingle | Claire Mitchell Abigail Tazzyman Susan J. Howard Damian Hodgson More that unites us than divides us? A qualitative study of integration of community health and social care services BMC Family Practice Integration Community services Health care Social care Qualitative research |
| title | More that unites us than divides us? A qualitative study of integration of community health and social care services |
| title_full | More that unites us than divides us? A qualitative study of integration of community health and social care services |
| title_fullStr | More that unites us than divides us? A qualitative study of integration of community health and social care services |
| title_full_unstemmed | More that unites us than divides us? A qualitative study of integration of community health and social care services |
| title_short | More that unites us than divides us? A qualitative study of integration of community health and social care services |
| title_sort | more that unites us than divides us a qualitative study of integration of community health and social care services |
| topic | Integration Community services Health care Social care Qualitative research |
| url | http://link.springer.com/article/10.1186/s12875-020-01168-z |
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