Integrated care systems are now legally responsible for leading a localised approach that brings multiple aspects of the healthcare system closer together, and for working better with social care and other public services. However, this is not a new aspiration, so why should it be any different this time? The Nuffield Trust hosted a series of roundtables to discuss concerns with stakeholders and experts to try and understand how to ensure the aims are achieved. This report summarises these findings and offers ways forward as the new era gets underway.
The workshops found five main risks to integration that appear to remain unresolved by current reforms. These are:
- Embedded culture and behaviours and inter-organisational power dynamics
- Organisational complexity, duplication, and overlapping focus
- Resource constraints
- Difficulties in defining, measuring and evaluating integration
- Integration fatigue.
In response, this report offers some suggested approaches to mitigating those risks, which should be the focus of system leaders as partnerships take hold. These include:
- Ways of building integration into the day job
- Bringing clarity to the complexity of governance structures
- Better use of performance management, metrics and data
- Fostering culture change through greater mutual understanding
- Rebalancing capacity, including management capacity.
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