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Case Reports
. 2024 Jul 2;24(3):4.
doi: 10.5334/ijic.7738. eCollection 2024 Jul-Sep.

Floundering or Flourishing? Early Insights from the Inception of Integrated Care Systems in England

Bethan Page  1   2 , Thavapriya Sugavanam  3 , Ray Fitzpatrick  4 , Helen Hogan  5 , Mirza Lalani  5
Affiliations
Case Reports

Floundering or Flourishing? Early Insights from the Inception of Integrated Care Systems in England

Bethan Page et al. Int J Integr Care. .

Abstract

Background: In 2022, England embarked on an ambitious and innovative re-organisation to produce an integrated health and care system with a greater focus on improving population health. This study aimed to understand how nascent ICSs are developing and to identify the key challenges and enablers to integration.

Methods: Four ICSs participated in the study between November 2021 and May 2022. Semi-structured interviews with system leaders (n = 67) from health, social and voluntary care as well as representatives of local communities were held. A thematic framework approach supported by Leutz's five laws of integration framework was used to analyse the data.

Results: The benefits of ICSs include enhancing the delivery of good quality care, improving population health and providing more person-centred care in the community. However, differences between health and social care such as accountability, organisational/professional cultures, risks of duplicating efforts, tensions over funding allocation, issues of data integration and struggles in engaging local communities threaten to hamper integration.

Conclusions: Despite ICS's investing in the structural and relational components of integrated care, the unprecedented pressures on systems to reduce demand on primary and emergency care tackling elective backlogs may detract from a key goal of ICSs, improving population health and prevention.

Keywords: Integrated Care Systems; Integration; population health; system reorganisation.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Integrated Care Systems (ICSs) in England and how they work
Figure 1
Integrated Care Systems (ICSs) in England and how they work.
Leutz’s Five Laws of Integration [16]
Figure 2
Leutz’s Five Laws of Integration [16].
See this image and copyright information in PMC

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