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- Title
Identifying and mobilising knowledge of 'what works' in an integrated care programme.
- Authors
Mulla, Abeda; Aldridge, Shiona; Lemiech, Ruth; Clarke, Eddie; Kelly, Helen
- Abstract
Introduction: The Integrated Care and Support Solihull (ICASS) Programme was launched in 2014 and aims to deliver sustainable and high quality integrated health and social care services to the people of Solihull (a metropolitan borough in the West Midlands, England) through a long-term strategic approach. The programme consists of three 'workstreams': Prevention and Early Intervention, Out of Hospital Care and Hospital Transformation. These are each associated with a number of specific integrated care projects. To date, ICASS activities have focused on developing a system approach to managing and delivering the programme with most project implementations to begin in the summer of 2015. Methodology: The Strategy Unit (Midlands and Lancashire Commissioning Support Unit, National Health Service, England) place this in the context of the evidence-base in order for ICASS to refine programme management and implementation. The study design was co-produced with the ICASS director to ensure its relevance. We conducted a rapid review of the literature which focused on: integrated care measurements; reported outcomes; and enablers and barriers to successful integration. We also conducted thirteen semi-structured interviews with ICASS Programme Board members, this included senior representatives from health and social care organisations, commissioners and providers as well as the voluntary sector and service users. The interviews were transcribed and the data thematically analysed and mapped against the eight Advancing Quality Alliance (AQuA) Integrated Care domains of system level integration (1). Key Findings: We found system leadership of ICASS and collaborative working at senior level to be the programme's well-recognised strength. Improvements could be made by system leaders engaging others to both lead and deliver the integrated care projects, within and across individual organisations. Particular emphasis was needed to engage Primary Care more widely and incorporate service user and carer views more consistently. The governance of the programme was deemed sufficient; however individual organisations accountability to the ICASS programme, financial risk-sharing, workforce development and information sharing across the patient pathway still needed further consideration. For example, whilst a regular meeting of Finance Directors had been set-up through ICASS to facilitate transparency and understanding of different organisational financial positions, a mechanism to integrate finances for ICASS purposes was still lacking. Highlights: Triangulated findings from the evidence and the interviews highlighted the need for consistency and system alignment in delivering ICASS with all stakeholders, and not limiting promotion to the senior programme management tier. Findings revealed potential for partner organisations to embed ICASS within their own organisations by promoting leadership and training for improvement know-how and personal effectiveness in middle management and frontline tiers. Conclusion: The knowledge transfer of the combined findings from the evidence-base and the interviews has shown the ICASS programme board where efforts need to be more concentrated both with respect to programme delivery and evaluation. Identification of the methodological weaknesses in previous reports of integrated care has mobilised ICASS to undertake a rigorous longitudinal, mixed methods evaluation of their programme in order to contribute to the evidencebase.
- Subjects
SOLIHULL (England); ENGLAND; HEALTH programs; MEDICAL quality control; PUBLIC health
- Publication
International Journal of Integrated Care (IJIC), 2015, Vol 15, p203
- ISSN
1568-4156
- Publication type
Article