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Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?

INTRODUCTION: For more than a decade the English NHS has pursued integrated care through three national pilot programmes. The independent evaluators of these programmes here identify several common themes that inform the development of integrated care. DESCRIPTION: The three pilot programmes shared...

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Autores principales: Lewis, Richard Q., Checkland, Kath, Durand, Mary Alison, Ling, Tom, Mays, Nicholas, Roland, Martin, Smith, Judith A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555475/
https://www.ncbi.nlm.nih.gov/pubmed/34754281
http://dx.doi.org/10.5334/ijic.5631
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author Lewis, Richard Q.
Checkland, Kath
Durand, Mary Alison
Ling, Tom
Mays, Nicholas
Roland, Martin
Smith, Judith A.
author_facet Lewis, Richard Q.
Checkland, Kath
Durand, Mary Alison
Ling, Tom
Mays, Nicholas
Roland, Martin
Smith, Judith A.
author_sort Lewis, Richard Q.
collection PubMed
description INTRODUCTION: For more than a decade the English NHS has pursued integrated care through three national pilot programmes. The independent evaluators of these programmes here identify several common themes that inform the development of integrated care. DESCRIPTION: The three pilot programmes shared the aim of better coordination between hospital and community-based health services and between health and social care. Each programme recruited local pilot sites that designed specific interventions to support inter-professional and inter-organisational collaboration. The pilots were highly heterogenous and results varied both within and between the three programmes. While staff were generally positive about their achievements, pilots had mixed success especially in reducing unplanned hospital admissions. Common facilitators to achieving pilots’ objectives included effective senior leadership and shared values, simple interventions and additional funding. Barriers included short timescales, poor professional engagement, information and data sharing problems, and conflicts with changing national policy. DISCUSSION: There was little stable or shared understanding of what ‘integrated care’ meant resulting in different practices and priorities. An increasing focus on reducing unplanned hospital use among national sponsors created a mismatch in expectations between local and national actors. CONCLUSION: Pilots in all three national programmes made some headway against their objectives but were limited in their impact on unplanned hospital admissions.
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spelling pubmed-85554752021-11-08 Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes? Lewis, Richard Q. Checkland, Kath Durand, Mary Alison Ling, Tom Mays, Nicholas Roland, Martin Smith, Judith A. Int J Integr Care Policy Paper INTRODUCTION: For more than a decade the English NHS has pursued integrated care through three national pilot programmes. The independent evaluators of these programmes here identify several common themes that inform the development of integrated care. DESCRIPTION: The three pilot programmes shared the aim of better coordination between hospital and community-based health services and between health and social care. Each programme recruited local pilot sites that designed specific interventions to support inter-professional and inter-organisational collaboration. The pilots were highly heterogenous and results varied both within and between the three programmes. While staff were generally positive about their achievements, pilots had mixed success especially in reducing unplanned hospital admissions. Common facilitators to achieving pilots’ objectives included effective senior leadership and shared values, simple interventions and additional funding. Barriers included short timescales, poor professional engagement, information and data sharing problems, and conflicts with changing national policy. DISCUSSION: There was little stable or shared understanding of what ‘integrated care’ meant resulting in different practices and priorities. An increasing focus on reducing unplanned hospital use among national sponsors created a mismatch in expectations between local and national actors. CONCLUSION: Pilots in all three national programmes made some headway against their objectives but were limited in their impact on unplanned hospital admissions. Ubiquity Press 2021-10-29 /pmc/articles/PMC8555475/ /pubmed/34754281 http://dx.doi.org/10.5334/ijic.5631 Text en Copyright: © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
spellingShingle Policy Paper
Lewis, Richard Q.
Checkland, Kath
Durand, Mary Alison
Ling, Tom
Mays, Nicholas
Roland, Martin
Smith, Judith A.
Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title_full Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title_fullStr Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title_full_unstemmed Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title_short Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes?
title_sort integrated care in england – what can we learn from a decade of national pilot programmes?
topic Policy Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555475/
https://www.ncbi.nlm.nih.gov/pubmed/34754281
http://dx.doi.org/10.5334/ijic.5631
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