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‘Trying to do a jigsaw without the picture on the box’: understanding the challenges of care integration in the context of single assessment for older people in England

Lookup NU author(s): Professor Rob WilsonORCiD, Dr Susan Baines, James Cornford, Professor Mike Martin



Abstract Introduction: Demographic ageing is one of the major challenges for governments in developed countries because older people are the main users of health and social care services. More joined-up, partnership approaches supported by Information and Communications Technologies (ICTs) have become key to managing these demands. This article discusses recent developments towards integrated care in the context of one of the arenas in which integration is being attempted, the Single Assessment Process (SAP) to support the care for older people in England. It draws upon accounts of local SAP implementations in order to assess and reflect upon some of the successes and limitations of service integration enabled by ICTs . Description of care (or policy) practice At the Department of Health in England policy and strategy are directed at the integration of services through a ‘whole systems’ approach, with services that are interdependent upon one another and organised around the person that uses them. The Single Assessment Processes (SAP) is an instance of inter-organisational and cross-sector sharing of information intended to improve communication and coordination amongst professions and agencies and support more integrated care. The aim of SAP is to ensure that older people receive appropriate, effective and timely responses to their health and social care needs and that professionals do not duplicate each others efforts. This article examines examples from two programmes of work within the context of SAP in England, one with the direction coming from local government social services the other where the momentum is coming from the National Health Service (NHS). Conclusion and discussion: Both examples show that the ‘whole systems’ policy and practice of integration supported by ICTs continue to represent a significant challenge. The authors highlight these cases to signal that although integration of care underpinned by ICT enabled information sharing is persuasive as an ideal, it has limitations in practice. The notion of an ‘open systems’ approach is proposed as an alternative way of improving communication and coordination across the domains of health and social care.

Publication metadata

Author(s): Wilson RG, Baines S, Cornford JR, Martin MJ

Publication type: Article

Publication status: Published

Journal: International Journal of Integrated Care

Year: 2007

Volume: 7

Pages: 1-11

ISSN (electronic): 1568-4156

Publisher: Igitur Publishing and Archiving Services