Horizontal or Vertical: Which way to integrate?: Approaches to community services integration and consequences for emergency hospital activity: A case study based on the Transforming Community Services Policy

The Strategy Unit, Midlands and Lancashire CCG, June 2018

This report explores the impact integration choices made by Primary Care Trusts had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems. It reflects on policies that lead to structural change. In 2010-11, emphatic and definitive claims were made about the benefits of Transforming Community Services. Substantial resources were used to develop plans and extensive assurance processes were put in place to check that these would deliver the changes required. But as far as we can tell, no attempt was made to test whether the promised benefits were realised.  Eight years on from this reform and familiar claims are being made about benefits of structurally integrating services. Management teams are exploring options and developing plans and regulators are establishing new assurance frameworks. The question of whether and how to structurally integrate services lies at the heart of this process. This paper attempts to draw out the lessons from Transforming Community Services for those wrestling with this question.

Click here to view this report.

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