An evaluation of integrated
care services: Learning from
two teams
MASLIN-PROTHERO Sian1, BENNION Amy2
1 Research
Institute for Life Course Studies, Keele University, Keele, Staffordshire, United Kingdom, ST5 5BG
2Aston University, Aston Triangle, Birmingham, B4 7ET
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Context
• National policy:
– health and social care integration
– provision and commissioning of services
• Local policy
– City council
– Two models of integrated health and social care
• dedicated lead worker (city wide)
• multi-disciplinary (co-located, single locality)
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Mixed methods
• Systematic literature review (Maslin-Prothero
and Bennion 2010).
• Semi-structured interviews; focus groups;
observation; case studies; client interviews;
client feedback sheets; documentary analysis
• Rapid and continuous thematic analysis
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Results: themes
• Key themes
– management;
– change;
– knowledge;
– communication;
– systems.
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Results: shared issues
• Shared issues:
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Cultural differences
Needs of the service user
Managing change
Communication with external agencies
Information Technology (IT) systems
Sharing and exchanging information between services
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Implications for social inclusion
“...a lot of the time you get people who will
classically not engage, they might be depressed, anxious
[and don’t engage] for that reason... And I think a lot of
the breakthroughs we have as a team is because of the
communication, we actually get them to engage with
services.” Community support officer (City-wide team)
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Implications for social inclusion
“...when you tell them ‘Oh well, I sit in an office with that
social worker, or with that district nurse’. You just get
this great response from them... it’s like a sign of relief...
I think they feel like a real person then and not just a
number in a tray.” Occupational therapist (Co-located team)
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Implications for social inclusion
• Elderly man, lives alone, registered blind, severe
hearing difficulties
• Initial assessment:
– district nurses in co-located team
– referred to: the community support officer, occupational therapist, social
worker.
• Client now has:
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falls and smoke monitor;
meals on wheels;
home improvements;
attends a day care centre;
increasing social engagement
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG
Discussion and conclusion
• Health, social care and housing model should
continue to be service user focused;
• Services should be provided by dedicated
neighbourhood teams;
• IT systems should be compatible across services;
• Secure, joint funding for these services:
– security for staff, and
– services to the local population.
Research Institute for Life Course Studies, Keele University, Keele, UK, ST5 5BG