Abstract
The aims and objectives of integration are often well rehearsed by policymakers, but limited attention has been given to how they try to use policy to achieve them – and whether it has worked. Our session will bring together international policymakers to discuss the effectiveness of national policy in driving collaborative working across health and social care, and how to improve it.
We will present evidence from our analysis across the UK on how intensive policy efforts towards integrated care have struggled to show measurable results. We will then chair a structured, open discussion creating space for attendees to learn more from one another’s’ experiences of delivering integration policies.
Our session will be aimed at national policymakers and local leaders working to integrate care. We will ask delegates to use slido to express views and interests throughout the session, creating quickfire prompts for discussions that reflect the focus in the room. We may write a comment piece for our Nuffield Trust website summarising key lessons and insights.
Session plan
Presentation (20 minutes)
We will begin with a presentation laying out our analysis of major integration initiatives in the four UK countries; the goals; the policy levers used; and the results. This will draw from and update our mixed-methods analysis published in 2021 which included a thematic policy analysis across the UK’s four countries, literature review, and quantitative data analysis of a number of key indicators, including spending, emergency admissions, and service user satisfaction. Our research is available here: https://www.nuffieldtrust.org.uk/sites/default/files/2021-12/integrated-care-web.pdf
We find few measurable and well-defined examples of success. Aims and policy approaches were not well supported by the literature. Goals were often poorly defined, data often not available, and aspirations for large financial savings lacking supporting evidence. Policymakers emphasised changes in governance over culture and resourcing.
Discussion: sharing experiences (20-35 minutes depending on session length)
In our first discussion period we will ask delegates to reflect on whether this mirrors experiences in their services and countries. We will encourage reflection on whether goals and objectives have been realistic and measurable, and whether there are good examples of learning and success.
Discussion: how can policies make integration work? (20-35 minutes depending on session length)
We will then run through some common policy levers for integration, such as joint governance, integrated finances, transformation funding, and performance management and accountability, to open up to a discussion on how effective these are. We want delegates to share successful or unsuccessful national policy experiences, local barriers and enablers they encountered, and possible unintended consequences.
We will sum up both discussions at the end of this period, capturing international lessons on what integrated care can measurably achieve and how policymakers can help bring this about. This will provide important comparative context for understanding how to improve policy in an area which is now a rising priority globally, but where approaches are only beginning to be improved and refined.