Integration of health and social care in the UK: implementation of policy into practice

PURPOSE: To explore the integration of health and social care in the UK through policy and clinical guidelines and to examine how partnership working and case management enables policy to be embedded into local practice. CONTEXT: The UK Department of Health policy document (White Paper 2006) Our Health, Our Care, Our Say: a new Direction for Community Services [1] focused on a new direction for the whole health and social care system. DESCRIPTION: The paper and subsequent action plans targeted the way services are provided, placing greater choice and control in the hands of people who use them. Health and Social Care services were tasked with becoming better integrated to meet the needs and wishes of individuals with chronic illness and long-term needs. The UK's National Service Frameworks and NICE guidelines are being implemented at local level to achieve management of chronic illness through effective case management and roles are being evaluated to show the effect of interventions [2]. The Government report Our NHS, Our Future [3] encourages a response to the needs of local communities through integrating care to ensure that services are shaped around the user not the organisation. DISCUSSION: We know that people with chronic illness are intensive users of services; that repeat admissions to hospital cause untold distress and that this vulnerable group is increasing as our population ages. We also know that inappropriate and increased use of services causes a financial burden in both primary and secondary care. Managed care through effective case management, if adopted flexibly, presents an opportunity to focus on reducing costs whilst appropriately managing the health needs of the target population.