Advancing Integrated Health and Social Care in Wales: Evidence for Change and Sustainability

Background: The Welsh Government’s Regional Integration Fund (RIF) is a five-year, £146 million programme (2022–2027) aimed at embedding inclusive, innovative models of integrated health and social care within a national Integrated Community Care System (ICCS). Central to this transformation is a robust data and reporting framework that ensures transparency and accountability across Wales’ seven Regional Partnership Boards (RPBs).

 

Approach: Welsh Government RIF Outcomes Framework, co-developed with RPBs, comprises 20 core measures designed to evaluate progress in delivering integrated care and its impact on individuals and communities; understanding the difference made to people. These measures reflect the principles and values of A Healthier Wales (2018), including person-centred care, prevention, seamless service delivery, a strong commitment to diversity and inclusion and having a shared vision across sectors.

The framework captures both quantitative and qualitative data, focusing on individual wellbeing, system performance, cost-effectiveness, and workforce development. It applies across priority population groups: older people, children and young people with complex needs, individuals with learning disabilities and neurodevelopmental conditions, unpaid carers, those with emotional and mental health needs, and care-experienced children and families.

To support consistent evaluation, a technical handbook was developed, guiding data collection using a modified Results Based Accountability™ (RBA) approach. Delivery partners also use tools such as “distance travelled” metrics and case studies to demonstrate impact, particularly in diverse community settings and how people are enabled to remain at home at long as possible and when in a hospital setting are discharged in a timely manner with support.

 

Results: Structured reporting aligned with RBA has enabled consistent, meaningful evaluation across RPBs while allowing flexibility to reflect local contexts. This balance has strengthened monitoring and supported the development of sustainable, evidence-informed models of care. Emphasis on data quality has been central—not as a bureaucratic exercise, but as a foundation for learning, adaptation, and continuous improvement.

The 20 core measures are dynamic tools for change. Informed by stakeholder feedback, they evolve with the programme, ensuring integrated care is not only delivered but continuously refined. These measures are shaping policy, guiding investment, and driving better outcomes through co-designed services that reflect the needs and voices of diverse communities.

 

Implications: RIF has played a pivotal role in reshaping service delivery and improving population health outcomes across Wales. Its long-term success depends on how deeply integrated approaches become embedded in everyday practice. The structured use of core measures offers a robust, outcomes-focused evaluation framework with international relevance.

By fostering cross-sector collaboration, enhancing transparency, and promoting evidence-informed decision-making, the RIF provides a scalable blueprint for other nations seeking to transform health and social care. Its emphasis on shared accountability, inclusive service design, and improved data quality and use strengthens the foundation for sustainable integration across health and social care. Ultimately, RIF’s approach supports the vision of integrated community care as a standard in public service delivery—responsive to the needs of all individuals and communities.