Table 1
Table to show the initial databases searched, dates searched, search terms used and number of journal articles available (Total number=488)
| Database | Date | Search terms | Hits |
|---|---|---|---|
| AMED via EBSCO | 16/01/09 | Interprofessional and integrated | 2 |
| AMED via EBSCO | 16/01/09 | Interprofessional and health and social care | 4 |
| AMED via EBSCO | 16/01/09 | Interprofessional and joint working | 0 |
| AMED via EBSCO | 16/01/09 | Interprofessional and shared services | 0 |
| AMED via EBSCO | 16/01/09 | Integrated and health and social care | 16 |
| AMED via EBSCO | 16/01/09 | Integrated and multi-agency | 4 |
| AMED via EBSCO | 16/01/09 | Integrated and joint working | 3 |
| AMED via EBSCO | 16/01/09 | Integrated and shared services | 0 |
| AMED via EBSCO | 16/01/09 | Multi-agency and joint working | 1 |
| AMED via EBSCO | 30/01/09 | (Integrated or interprofessional) and health and social care and (multi-agency or joint working or shared services) | 7 |
| AMED via EBSCO | 30/01/09 | (Inter-professional or interprofessional) and health and social care | 22 |
| AMED via EBSCO | 30/01/09 | Integrated and health and social care | 16 |
| CINAHL via EBSCO | 16/01/09 | Inter-professional and integrated | 12 |
| CINAHL via EBSCO | 16/01/09 | Inter-professional and health and social care | 9 |
| CINAHL via EBSCO | 16/01/09 | Inter-professional and multi-agency | 1 |
| CINAHL via EBSCO | 16/01/09 | Inter-professional and joint working | 1 |
| CINAHL via EBSCO | 16/01/09 | Inter-professional and shared services | 0 |
| CINAHL via EBSCO | 16/01/09 | Integrated and health and social care | 149 |
| CINAHL via EBSCO | 16/01/09 | Integrated and multi agency | 34 |
| CINAHL via EBSCO | 16/01/09 | Integrated and joint working | 23 |
| CINAHL via EBSCO | 30/01/09 | (Integrated or interprofessional) and health and social care (multi-agency or joint working or shared services) | 16 |
| CINAHL via EBSCO | 30/01/09 | Inter-professional and integrated | 12 |
| CINAHL via EBSCO | 30/01/09 | Inter-professional and health and social care | 9 |
| CINAHL via EBSCO | 30/01/09 | Integrated and multi-agency | 33 |
| Web of Science | 07/02/09 | (Integrated or interprofessional) and health and social care (multi-agency or joint working or shared services) | 114 |
Table 2
Additional databases searched, dates searched, search terms used and number of journal articles available (Total number=1570)
| Database | Date | Search terms | Hits |
|---|---|---|---|
| Social Care Online | 25/01/2010 | Interprofessional and integrated | 80 |
| Social Care Online | 25/01/2010 | Interprofessional and joint working | 112 |
| Social Care Online | 25/01/2010 | Interprofessional and shared services | 0 |
| Social Care Online | 25/01/2010 | Integrated and multi agency | 31 |
| Social Care Online | 25/01/2010 | Integrated and joint working | 173 |
| Social Care Online | 25/01/2010 | Integrated and shared services | 0 |
| Social Care Online | 25/01/2010 | Multi-agency and joint working | 43 |
| Social Care Online | 25/01/2010 | (Integrated or interprofessional) and health and social care (multi-agency or joint working or shared services) | 0 |
| Social Care Online | 25/01/2010 | (Inter-professional or interprofessional) and health and social care | 411 |
| Social Care Online | 25/01/2010 | Integrated and health and social care | 661 |
| Pubmed | 25/01/2010 | (Integrated or interprofessional or inter-professional) and health and ‘social care’ (‘multi-agency’ or ‘joint working’ or ‘shared services’) | 19 |
| Pubmed | 25/01/2010 | (Integrated or interprofessional) and health and ‘social care’ (multi-agency or joint working or shared services) | 40 |
Table 3
Details collected from the reviewed articles (n=18)
| Study | Aim | Method and sample | Outcomes | Conclusions |
|---|---|---|---|---|
| Armitage, G.D., Suter, E., Oelke, N.D., and Adair, C.E. (2009). Health systems integration: state of the evidence. International Journal of Integrated Care, 9, 82–91. | Identify definitions of integration, models, measurement tools indicators and outcomes of integration and universal principles common to successful integration. | Systematic literature review. | Significant gaps in the research literature. No universal definition of integration and multiple integration models. Lack of standardized, validated tools to evaluate integration. | Need for; clear standards for monitoring success and failure of integrated health systems; validated measurement tools; comprehensive case studies; comparative analyses of different approaches to integration. |
| Brown, L., Tucker, C., and Domokos, T. (2003). Evaluating the impact of integrated health and social care teams on older people living in the community. Health and Social Care in the Community, 11, 85–94. | Comparison of users serviced by integrated team and traditional care arrangements. | Non-randomized comparative design over 18 months. | More people died in the traditional team than in the integrated team; more people in the integrated team went into residential placement. Integrated teams were significantly quicker to respond than non-integrated although relatively high level of missing data. Service users were older and more depressed—might explain why more went into residential care. Service users had little interest in who organized their services, as long as they received what they felt they were entitled to | There is a need for integrated services to be embedded and for efficient and effective information systems. |
| Cameron, A., Macdonald, G., Turner, W., and Lloyd, L. (2007). The challenges of joint working: lessons from supporting people health pilot evaluation. International Journal of Integrated Care, 7, 1–10. | Understand the process and outcomes of the interventions. To determine what works, for whom and in what circumstances. | Evaluation of six pilots funded by ‘Supporting People’ services. Data collection: project evaluation reports, semi-structured interviews with key stakeholders and service users. | Success assisted by: a shared understanding of the purpose of the joint venture; past history of joint working; and clear governance arrangements. The extent and nature of statutory participations and a history of voluntary sector involvement affects the success of the integrated partnerships. Voluntary agencies are less inhibited by organizational structures and agendas, allowing more flexibility towards the needs of the service user. | Increase the role of the voluntary sector in health and social care services. Reorganization of agencies is a constant threat and changes in personnel unsteady partnerships created. |
| Campbell, J., and McLaughlin, J. (2000). The ‘joined up’ management of adult health and social care services in Northern Ireland: lessons for the rest of the UK? Managing Community Care, 8, 6–13. | Describe and critically analyse the development of integrated service in Northern Ireland. | Review of the literature. | Need for research of integrated service. Resources required for implementation of integrated care/teams. Needs of user and carers. | Need for further research. |
| Coxon, K. (2005). Common experiences of staff working in the integrated health and social care organizations: a European perspective. Journal of Integrated Care, 13, 13–21. | The common experiences of staff working in integrated health and social care organizations across Europe. | Qualitative methodology: questionnaire led interviews and focus groups. 18 case studies across Europe. | Benefits of integrated working: job satisfaction, improved team working, good communication and enhanced co-operation with other agencies. Disadvantages were social care staff working alongside medical staff and the divide between these disciplines. Organizational boundaries included staff feeling; unrealistic expectations of integrated working provided the tools to identify client problems, financial limit on what could be tackled with the resources available. Short-term contract working, a lack of clear career structure, limited opportunities for promotion. | Trade-off between present job satisfaction and future career progression for staff in integrated care teams. |
| Davey, B., Levin, E., Iliffe, S., and Kharicha, K. (2005). Integrating health and social care: implications for joint working and community care outcomes for older people. Journal of Interprofessional Care, 19, 22–34. | Comparison of two models of joint working. | Standardized interviews. Compared co-location and non co-location. | Cognitive impairment of older people is key factor in their ability to remain in their own homes. Contact with social care in general practice records frequently under-documented. | Address under documentation of the contact with social care. Emphasis on process of team working at individual level. Take account wider context: characteristics, circumstances, services received by older people. |
| Heenan, D., and Birrell, D. (2006). The integration of health and social care: the lessons from Northern Ireland. Social Policy and Administration, 40(1), 47–66. | Identify and discuss key issues associated with integration based on experiences in Northern Ireland. | Exploratory qualitative research. Semi-structured interviews. | Degree of integration varies with programme of care. Duplication of services is avoided through a coordinated approach and single point of access. Integrated management leads to parity of esteem between professions. Forum for affective management of tensions between professions. Health model is dominant over social services. | Integrated services in Northern Ireland (NI) are under researched. Successes in should be duplicated, e.g. shared funding; goals and objectives; work places; and management. Need for integrated disciplinary training. Equality in health and social services is needed—health model dominate. |
| Holton, M. (2001). The partnership imperative: joint working between social services and health. Joint Management in Medicine, 6, 430–455. | Exploration of the partnership between social services and primary care. | Case study. Use of theoretical framework. Semi-structured interviews with a range of stakeholders. | Transformational leadership skills. Erosion of traditional boundaries. Warmth of cross agency relationship. | Functional links and tackling cultural issues. |
| Hubbard, G., and Themessl-Huber, M. (2005). Professional perceptions of joint working in primary care and social care services for older people in Scotland. Journal of Interprofessional Care, 19, 371–385. | Health and social care professionals perceptions on joint working for older people in Scotland. | Qualitative methodology. Interviews. | Difference between managers and front line staff. Managers focused on policy implications of changes to services. Front line staff need to improve the practicalities of joint working. | Biggest challenge ‘fundamental change in thinking’ at a policy, management and service delivery level. Team building activities, promotions, co-location and formalization of links between the services are required. Environment to be conductive to collaborating; need for clear strategic vision; planning and a whole systems way of thinking; ability to exchange knowledge easily; effective IT system. Include service user perspective. |
| Hudson, B. (2002). Interprofessionality in health and social care: the Achilles' heel of partnership? Journal of Interprofessional Care, 1, 7–17. Hudson, B. (2006). Integrated team working: you can get it if you really want it: Part 1. Journal of Integrated Care, 14, 13–21. Hudson, B. (2007). Pessimism and optimism in the inter-professional working: the Sedgefield Integrated Team. Journal of Interprofessional Care, 21, 3–15. | Two models of inter-professional working. | Literature review. Case study. Mixed methods (documentary analysis, questionnaires, interviews). | Co-located team evaluation at two time points over one year. Focus on ‘whole person’. Difference in culture does not impede shared approach. Important factors: team selection (choice), parity of esteem, co-location, reorientation of professional affinity. More effective service delivery and user outcomes, speed, flexibility and creativity. | Support for optimistic model, successes results from—right people, right place, right time; and self selected team members. |
| Hudson, B. (2005). Grounds for optimism. Community Care, 01.12.05, 34–35. | Report the findings of the Sedgefield integrated teams programme. | Optimistic findings of the success of integration. Team members showed: parity of esteem; acceptance of the judgement of others; reorientation of professional affinity. | Transformational change is possible. Need for the government to develop integrated performance targets. | |
| Hultberg, E-L., Glendinning, C., Allebeck, P., and Lönnrothet, K. (2005). Using pooled budgets to integrate health and welfare services: a comparison of experiments in England and Sweden. Health and Social Care in the Community, 13(6), 531–541. | Prevent evidence of the impact of budget pooling in England and Sweden. | Postal survey. In depth-interviews with key stakeholders. | Importance of clear legal and financial frameworks. Short-term funding is difficult to manage in pooled budgets. Pooled budgets highlighted areas of duplication by health and social care staff. Staff problems arise in terms of: ‘soft’ issues (culture, training and attitudes), and ‘hard’ issues (employment terms and conditions). Differing IT systems led to information sharing problems. | Services focus on needs covered by their own budget: shared budgets may reduce this barrier to integration. Lack of evidence for beneficial outcomes, i.e. improvements for patients. Pooled budgets have the potential to transform organizational perspectives. |
| McCallin, A. (2001). Interdisciplinary practice—a matter of teamwork: an integrated literature review. Journal of Clinical Nursing, 10, 419–428. | The development of interdisciplinary practice. | Literature review. | Changing inter-professional interactions; role definition, support from management and appropriate training, and engagement in change management. | More research: processes which teams use in current context of health care; whether interdisciplinary practice improves outcome management. |
| Scragg, T. (2006). An evaluation of integrated team management. Journal of Integrated Care, 14, 39–48. | Evaluation of integrated team management (ITM) in a health and social care trust. | Questionnaire semi-structured interviews. Third stage, meetings with two groups of service users. | Themes and relationships identified. | Need to continually reinforce vision of integrated working. Organizational and personal development opportunities should be provided for staff. Impact of different systems and processes should be acknowledged. Access to professional supervision and support is crucial to ensure professional standards. Services need to identify meaningful ways of involving service users in process of service change. |
| Stewart, A., Petch, A., and Curtice, L. (2003). Moving towards integrated working in health and social care in Scotland: from maze to matrix. Journal of Interprofessional Care, 17, 335–350. | Drivers and barriers to integrated working. | Case studies (9) of community care practices in Scotland. Expert Witness Panel. Scenario Planning Workshops. Interviews with range of key stakeholders. | Drivers: national policy frameworks, local planning contexts, and operational factors. Barriers: timing, planning and no history of joint working. Successful cultural aspects for integrated working; teams that are open, ready to learn, and prepared to allow for both risk and failure. Establish agreed roles and responsibilities, supported with training, rewarded for successes. Encouraged to work creatively, given a high level of trust, take risks and challenge current ways of working. | Recording positive experiences and successes and feeding these back to staff members can help to reassure staff. Early involvement of relevant stakeholders promotes shared vision and ownership of the process. |
| Warne, T., McAndrew, S., King, M., and Holland, K. (2007). Learning to listen to the organizational rhetoric of primary health and social care integration. Nurse Education Today, 27, 947–954. | Moving to a fully integrated health and social care service. | Survey, semi structured interviews. Stake holder workshops. Analysed using descriptive statistical analysis. Interviews and workshops were transcribed and submitted to context and content analysis. | Survey: organizational roles, strategic working, tactical working, operational working, interpersonal relationships, cultural integration, educational integration, best practice. Workshops and interviews: team working, communication, role awareness, personal and professional development, partnership working, and practice development and leadership. Rhetoric: rational, technical, normative, fantasy. | Taking time out—away days. Opportunity to engage. Invest in personal, professional and organizational development. |
| Wistow, G., and Waddington, E. (2006). Learning from doing: Implications of the Barking and Dagenham experience for integrating health and social care. Journal of Integrated Care, 14, 8–18. | Evaluation of integrated provision and services. | Mixed methods: questionnaires, semi-structured interviews, documentary analysis. | Conflicting patterns of central and local relationships; tension structure and culture. | Routes to improved outcomes; integrated governance. |