The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics.

This workshop will serve to launch the publication 'Long-term care in Europe-Improving policy and practice', edited by Kai Leichsenring, Jenny Billings and Henk Nies [1] and present selected issues and findings from a transversal analysis of themes and key-issues in constructing integrated long-term care, carried out on the basis of the FP7 Project INTERLINKS (http://interlinks.euro.centre.org).

Knowledge transfer (KT) between specialist and generic services is widely seen as an important strategy for improving the quality of integrated dementia care. This article elaborates on intra- and inter-organizational features associated with successful KT. A provisional conceptual framework is suggested, based on literature about inter-organizational networks and knowledge management. Professional and organizational cultures, domain perceptions, perceived dependency and the availability of resources are suggested as significant influences upon the motivation and perceived capacity to engage in KT. Personal and organizational continuity is identified as an important process quality. Data from four local case studies in England and The Netherlands are used to develop and specify the provisional framework. A conceptual model is built to explain the relative success or failure of KT.

In this article, the authors compare dementia care in England and the Netherlands. They used qualitative methods to explore recommended standards of service provision and perceived achievements in mainstream care. They found some similarities in recommended standards and in major shortcomings in mainstream services: notably, weaknesses of generic services in supporting patients and carers, and failure to achieve integrated care. Priorities regarding service provision differed. Whereas in England, a social model of care was used to encourage empowerment of both the person with dementia and the carer, Dutch care professionals focused more on "warm care concepts" and on support of the carer rather than the patient. The balance between community care and institutional care also differed. The authors used neo-institutionalist concepts to explore these similarities and differences as embedded in the (historically developed) structural and cultural contexts of the respective health and social care systems.

This article assesses how social innovations in the field of local domiciliary long-term care are shaped and implemented. It proposes a mapping of innovations in terms of two structuring discourses that inform welfare state reforms: a libertarian and a neoliberal discourse. It then provides an analysis of the concrete trajectories of three local innovations for elderly people in Hamburg (Germany), Edinburgh (Scotland) and Geneva (Switzerland). Theoretically, social innovation is considered as a discursive process of public problem redefinition and institutionalisation. New coalitions of new actors are formed along this double process, and these transform the original discourse of innovation. The comparative analysis of the three processes of institutionalisation of local innovation shows that, in the context of local policy making, social innovations inspired by a libertarian critique of the welfare state undergo differentiated processes of normalisation.