‘It is not a quick fix’ structural and contextual issues that affect implementation of integrated health and well-being services: a qualitative study from North East England

Abstract

These findings provide useful learning in terms of the delivery and commissioning of similar IHWSs, contributing to understanding of the benefits and challenges of this model of working.

Factors in implementation of clinical commissioning policy in improving health and wellbeing and/or reducing health inequalities in the English NHS: a systematic review of the evidence

“…We identi ed 2166 references, scanned 133 titles and abstracts and retrieved 42 publications for full texts. From these, we included six studies (including a total of 1155 participants) that reported data on clinical commissioning and health inequalities [46][47][48][49][50][51] and excluded 36 studies (Additional le 2). Of the six, four were qualitative.…”

“…Of the six, four were qualitative. [46][47][48][49] All studies were conducted between 2010 and 2017 and the list of included studies is presented in Table 2.…”

“…Participants in both sites felt there were new opportunities to work across local authority directorates to address the wider determinants of health and health inequalities. 48 There is wider consultation on decisions in the local council setting than in the NHS, and elected members now have a strong in uence on public health prioritisation. Greater recognition of public health objectives and expected outcomes in a wider range of council services as a result of public health investment.…”

“…51 Both local authorities had a long-term strategic commitment to community development and asset-based approaches, which was seen as bene cial by public health commissioners. 48 c) Partnership and engagement: The association between CC and wider healthcare partnership and engagement has been reported positively in terms of meeting healthcare needs by reducing duplication costs/resources and sharing knowledge and expertise. These studies conveyed this view:…”

“…The idea of offering a more streamlined accessible approach, which seeks to knit together a number of different functions was broadly welcomed. 48 GPC endorsement of the social model of health underpinning LWG and WFL, there was also broad acceptance of prevention and early intervention, recognised as being more cost-effective than long-term treatment. 48 Finding 3: All six papers (100%) indicated that there was some poor evidence for reducing health inequalities through the clinical commissioning process, primarily due to poor approaches utilised in decision-making, lack of budgets, time, strategic priorities, and poor commitments.…”