Removing the policy barriers to integrated care in England

Author: Chris Ham and Judith Smith

Publisher: Nuffield Trust


International experience demonstrates that integrating healthcare services can deliver more efficient, patient-focused care. The White Paper, Equity and Excellence: Liberating the NHS, provides an opportunity to develop integrated care systems.

In the UK, a number of health and social care organisations are at the forefront of this initiative, but there are several policy barriers to be overcome if these systems are to be adopted more widely. This briefing uses five cases studies of health economies in the English NHS and examines how local clinicians and managers are working together to develop more coordinated services.

The authors conclude that the reforms outlined in the NHS White Paper, such as handing groups of GPs commissioning responsibilities, accompanied by real budgets, have the potential to deliver more seamless care for patients. However, the experiences of the areas studied – Torbay, Nottingham, Redbridge, Trafford and Cumbria – indicate that policy in areas such as GP commissioning and local leadership, competition, incentives and regulation needs to be developed to better support moves towards integration. They also stress the need to involve both clinicians and members of the public in service redesign.

Removing the policy barriers to integrated care in England will be of interest to health and social care policy-makers and senior managers, clinicians, senior social care practitioners and others with an interest in NHS and social care reform.

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