The Building Blocks of Integrated Care

This special issue grows out of a collaborative project between IFIC and Edge Hill University (UK) that led to six webinars delivered by international experts on integrated care. 1 The papers are reflection pieces by those who delivered the webinars providing a unique summary of accumulated expertise in some of the most important themes in the integrated care field. This special issue also offers a good opportunity to reflect on progress and challenges in the field as care integration increasingly gains policy support and gathers momentum in many countries across the world. Integration of health and social care did not develop from a blank sheet. It grew out of long-standing concerns about care fragmentation and drew on a distinguished corpus of research on partnership and multi-agency collaboration in health and social care. Integration, just like its predecessor 'partnerships', carries largely positive connotations and thus quickly won support from policy makers resulting in a plethora of guidance documents and policy announcements. Despite the receptive wider context , integration remains a challenge for professionals and practitioners across the health and social care divide and the papers in this special issue address some of the most difficult barriers to implementing integrated care services. Although integrating health and social care services is nothing if not popular amongst policy makers, it is a field where success remains isolated, incidental and highly dependent on contingent factors, such as effective local leadership and transformational synergies across sectoral divides. There is widespread agreement however on the need for change brought on by a long term shift from acute episodic health needs to care needs around chronic conditions requiring col-laborative practices across the care continuum. As people live longer, health care systems are increasingly burdened by rising costs due to complex care needs that defy the traditional sector fault line between health and social care. Yet despite the consensus for positive change, it is this fault line that remains stubbornly resistant to change in the face of considerable research evidence. The reasons are multi-faceted. So-called barrier research has long identified professional and organisational cultures, values and practices as significant challenges to forging truly coordinated responses to complex care needs of patients. Again, scholars of integrated care can draw on a rich pool of empirical evidence originating in singular intervention sites addressing these barriers. Solutions range from boundary spanners to full organisational integration pilots in some areas. Yet, none of …