Table 1
TAPIC framework for analysing ‘good’ governance.
| ATTRIBUTE | DEFINITION |
|---|---|
| Transparency | Institutions make decisions and their grounds clear |
| Accountability | Mechanisms for giving an account of one’s actions and being held to account for those actions/explanations are clear |
| Participation | Affected parties have access to decision-making power |
| Integrity | Processes of representation, decision-making and enforcement are clearly specified |
| Capacity | Necessary expertise and resources to develop policy are available |
[i] Note: Adapted from Greer et al. [8].
Table 2
Overview of study sites.
| STUDY SITE | DESCRIPTION |
|---|---|
| Italy | |
| Azienda Zero (AZ), Veneto | AZ is a regional governance body, which centralises key functions previously carried out by local health authorities, including procurement, human resources, legal services and cash-flow management, and quality of health and social care in Veneto region. The nature and scope of its functions are set out in regional legislation. |
| Chronic care (Presa in carico del paziente cronico, PiC), Lombardy | PiC is a new approach to integrated management of chronic care, in which a care manager (GP or paediatrician) develops individual care plans (piano di assistenza individuale, PAI) and takes responsibility for coordinating care. Managing bodies act as the primary provider of services, either directly or through contracted partners. The PiC incentivised the creation of GP cooperatives as managing bodies. |
| Houses of health (Casa della salute, CdS), Emilia-Romagna | CdS (also referred to as ‘community health centre’ or ‘medical home’) oversee access to and the provision of health and social care services locally. They coordinate primary care with other service providers, including specialist and inpatient care, develop diagnostic and integrated care pathways along with prevention programmes, and manage chronic conditions through primary and specialist care integration. The region sets out the general framework and goals for the model, which the local health authorities adapt to their specific local context. |
| Netherlands | |
| Buurtzorg | Buurtzorg is a not-for-profit social enterprise home care company in which self-governing teams of nurses provide all aspects of home care, from personal care to more complex clinical care, in neighbourhoods across the Netherlands to provide more coordinated care. |
| Rotterdam Stroke Service (RSS) | RSS is the largest integrated stroke care network (‘stroke care chain’) in the Netherlands, formed by 17 health care organisations that work together to organise care for stroke patients during the acute, rehabilitation and chronic phase of patient care. The RSS is divided into seven sub-chains around each participating hospitals. |
| Sustainable Coalitions (Duurzame coalitie) | Sustainable Coalitions are long-term collaborations between the health insurer CZ and service provider organisations seeking to develop and implement innovative care approaches for defined populations. The aim is to shift from negotiating yearly contracts on price and volume to longer-term contracts of up to ten years based on a contract price. The Sustainable Coalitions are based on the principle of ‘co-creation’, aiming to develop a shared vision between the insurer and provider organisation(s). |
| ZIO (Zorg in Ontwikkeling) | ZIO is a primary care organisation (‘care group’) supporting general practitioners, physiotherapists and dieticians in the Maastricht-Heuvelland region to provide person centered-care for various target populations, including those with chronic conditions, older people, and people with mental health problems. ZIO is the main primary care contractor in the region and responsible for negotiating contracts with the health insurer on behalf of the care group as well as sub-contracting individual providers or provider organisations within the care group. |
| Scotland | |
| Dumfries and Galloway Integration Joint Board (IJB) | Dumfries and Galloway Integration Joint Board brings together NHS Dumfries and Galloway (regional health board) and the Dumfries and Galloway Council (local authority). The services delegated to the IJB include all adult health and social care for the region. Dumfries and Galloway IJB is the only IJB in Scotland with delegated authority for acute hospitals. |
| East Ayrshire Integration Joint Board (IJB) | East Ayrshire Integration Joint Board brings together NHS Ayrshire and Arran (regional health board) and East Ayrshire Council (local authority). The services delegated to the IJB include public health, nursing, children, young people and criminal justice services, social work for adults, mental health services, care home services, community care assessment teams and occupational therapy among others. |
| Highland Integration Partnership | Highland Integration Partnership brings together NHS Highland (regional health board) and Highland Council (local authority). Highland is the only area that adopted the Lead Agency model whereby NHS Highland has responsibility for adult health and social care services and Highland Council has responsibility for children’s health and social care services. |
[i] Note: Authors’ compilation based on country reports (available upon request).