Early findings from the evaluation of the Integrated Care and Support Pioneers in England

Abstract

PurposeIntegrating health and social care is a priority in England, although there is little evidence that previous initiatives have reduced hospital admissions or costs. Twenty-five Integrated Care Pioneers have been established to drive change 'at scale and pace'. The early phases of our evaluation (April 2014-June 2016) aimed to identify their objectives, plans and activities, and to assess the extent to which they have overcome barriers to integration. In the longer-term, we will assess whether integrated care leads to improved outcomes and quality of care and at what cost. Design/methodology/approachMixed methods involving documentary analysis, qualitative interviews and an online key informant survey. FindingsOver time, there was a narrowing of the integration agenda in most Pioneers. The predominant approach was to establish community-based multi-disciplinary teams focused on (older) people with multiple long-term conditions with extensive needs. Moving from design to delivery proved difficult, as many barriers are outside the control of local actors. There was limited evidence of service change. Research limitations/implicationsBecause the findings relate to the early stage of the 5+ years of the Pioneer programme (2014-19), it is not yet possible to detect changes in services or in user experiences and outcomes. Practical implicationsThe persistence of many barriers to integration highlights the need for greater national support to remove them. Originality/valueThe evaluation demonstrates that implementing integrated health and social care is not a short-term process and cannot be achieved without national support in tackling persistent barriers. AcknowledgementsThe authors would like to thank the members of staff in all the Pioneer sites who kindly agreed to be interviewed and to complete the online survey. We would also like to thank members of our PPI (patient and public involvement) Steering Group, who provided many helpful comments on documents and reports that formed part of our early evaluation. This work is an independent evaluation commissioned and funded by the Department of Health's Policy Research Programme. The views expressed are not necessarily those of the Department or its partners.

Can accountable care organisations really improve the English NHS? Lessons from the United States

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Introducing community integrated nursing teams: How one Clinical Commissioning Group applied an evidence-based approach

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