An analysis of how legislation has affected health and social care integration in Wales

Background: In Wales, the devolved government has taken a structural approach to health and social care integration through legislation, specifically with the Social Services and Well-being (Wales) Act 2014 which requires health and social care organisations to work together in seven Regional Partnership Boards (RPBs) across Wales to plan and deliver services to meet the needs of the population. This research considers how legislation has affected health and social care integration in Wales through thematic analysis of semi-structured interviews with members of Cardiff and Vale RPB.

 

Approach: This research used an inductive approach, interviewing 10 members of Cardiff and Vale RPB which is made up of senior leaders from organisations who contribute to the health and well-being of citizens in the Cardiff and Vale region as well as lived experience. The semi-structured interviews were thematically analysed to interpret generalisable themes on integration and the efficacy of legislation in Wales.

The five themes extracted showed: a common understanding of integration, a lack of clarity around the best mechanism for integration, extensive barriers to integration, inconsistency in the interpretation of legislation but generally a lack of mandate to integrate, and a mixture of positive and negative experiences of the RPB structure. The main limitation of this study is the sample of participants from a single RPB due to access and time constraints.

 

Results: This study finds that Welsh Government has attempted to address health and social care integration through legislation in the form of a structural response with the formation of seven RPBs across Wales. This research reinforces many of the findings within similar studies, particularly noting the importance of legislation in bringing partners together to support integration of services. However, my conclusions suggest that the mandate for integration does not go far enough in requiring organisations to integrate and participants clearly highlighted the importance of planning and collaborative leadership in partnership structures in order to fully capitalise on the potential benefits of integration.

 

 

Implications: This research provides insights into the views of Cardiff and Vale RPB members reflecting on the impact of legislation. Specifically, this research draws out the significance of leadership and planning within integrated structures which has not been explored in similar studies. This should be part of the consideration in strengthening workforce capacity and skills to include integrated planning which supports development of more integrated services.